Leadership by Walking Around:How Being Seen and Available Changes Everything

This transcript was generated automatically and may contain errors.

Melissa Gilkes-Smith: Welcome back to Touch Points. Throughout this season, we’ve been building a case pillar by pillar for what it takes to design a patient experience that earns trust. We’ve talked about first impressions, scheduling, technology, physician relationships, the clinical encounter. And underneath all of it, woven through every single pillar, is something that no framework can manufacture, no technology can replace. Culture. Specifically the culture of care. The lived values of accountability, compassion, empathy, collaboration that determine how a team actually shows up. Not in the mission statement, but in the moments that matter. And today I want to talk about where culture comes from. Because it doesn’t come from a values workshop or an all-staff email.

It comes from leadership, from what leaders do, where they go, and where they are present. Visibly, consistently, genuinely present in the work. There is a practice in organizational leadership called management by walking around. And in healthcare, I believe it’s one of the most powerful and underutilized tools we have for building a culture of care. My guest today has lived this in the United States Navy and across 25 years of healthcare leadership at every level. Dr. Edward Daniel is a retired Navy veteran, healthcare executive, and the founder and CEO of Patient-Centered Services, an organization built around exactly what the name says. Dr. Daniel has led healthcare organizations across military, for profit, and nonprofit settings.

He brings lean six sigma methodology, deep operational experience, and a leadership philosophy forged in one of the most demanding leadership environments that exist military service. What I want to explore with him today is what he’s learned across all of that experience about what happens when a leader is physically present, walking the floor, seeing the work being seen, and what it does to the people around them. Dr. Daniel, welcome to Touch Points.

Dr. Edward M. Daniel: Thank you. Thank you for having me, Miss Melissa. It’s a pleasure to be here.

Melissa Gilkes-Smith: Absolutely. Well, I want to start in the Navy because I think military context is where this idea of leadership presence becomes most concrete. In that environment, leadership visibility isn’t a management philosophy, it’s a survival standard. What did you learn about presence as a leader during your time in service?

Dr. Edward M. Daniel: So after over 21 years in the military, you learn really, really quickly. I think as soon as you become a petty officer, you uh become a leader. Uh you learn really, really quickly that leadership is not optional. Uh it’s operationally necessary. Um leaders who remain disconnected from the front line, they tend to lose credibility really, really quickly. So if I could sum it at one big under one umbrella, is that leadership presence is optional. It’s not optional. It’s necessary.

Melissa Gilkes-Smith: So when you moved over into healthcare leadership, what did you find? Was the same expectation of presence there, or did you walk into a completely different culture?

Dr. Edward M. Daniel: So I I think the the there was slight differences. Um same vein, but slightly different because it’s a different type of leadership structure. It’s not always do what I say without question. So it was slightly different. It’s more intentional. Um in the in the military, you you you do more inspecting, you do more policing, you do more supervising, more visual, um, visible, uh uh looking at things, micromanaging. Um on the civilian side, it’s a little bit a little bit more friendly. Uh we do more listening as leaders on the civilian side. You do more learning because you have to learn behavior patterns and things like that. When the military had to do what I say immediately, um and they follow orders.

Um, you more supporting roles. Um, you do more relationship building. That’s another really, really big deal. Um, that’s part of your leadership, that you must have that quality where you can build relationships to build teams. And then another big, a big key component of a difference would be problem solving. Um, you must learn to problem solve uh in in real time. Um, in the military, you practice for most of the things you’re going to encounter. And so you train the way you fight in the military, in the civilian sector, you’re doing more problem solving on the fly, a lot of things you hadn’t seen before. And so there’s slight differences. It’s more the military is more purpose, uh, purpose and uh more performative, and then civilian life is more uh purposeful.

So it’s kind of purposeful versus performative.

Melissa Gilkes-Smith: So management by walking around. Um, this has been a it’s a concept that’s been around since the 1980s, but I really think it gets misunderstood sometimes. People hear it and they think it means about wandering the halls or doing surprise inspections. So explain to us what does this actually mean and how do you do it well?

Dr. Edward M. Daniel: So management walking by walking around, it means it’s it simply put, it means being seen, being visible. Um it means that you’re you’re on the deck plate, you’re asking questions such as, um, uh, what made your day a little harder today? Um uh what do you need from leadership? Um what things can we do to improve how we’re what we’re doing and how we’re delivering the care we’re delivering. Um so here, management uh walking around me is more of just showing up. So the psychological barriers are able to come down. A lot of people feel as though when they don’t see you on a regular basis, when you show up is only when problems are happening in real time. They want to see you when there are no problems.

You can just imagine if you’re that worker in the emergency room and you’re working, and the CEO walks in and you’re you already are already in this hyper mode, and then the CEO walks in and just makes you more anxious, and now you’re wondering, am I doing my job right? So it’s a head thing, it’s a psychological deal. But when the CEO or leaders are constantly walking around, they’re constantly in your presence, you’re you can relax. You’re not in this anxious uh position anymore. You’re able to be more, become more effective because now it’s not, oh, they’re here because I’m in trouble. They’re here because there’s an issue, they’re here to solve a problem. No, they’re here because they want to know what you do, how you do it, and they want to make sure, hey, I understand you.

I see you. I know what your job, what it takes to do your job because I’m here with you. And so I think that it’s it releases that psychological barrier that can sometimes uh come up when people don’t see leadership often in the workspace. So I think the biggest deal about the MBWA degree, and I call it a degree because you do earn that thing by being present, is that you you really release the anxiety of the uh subordinates in the area by being there. They trust in the leadership.

Melissa Gilkes-Smith: You said deck plate, and of course that’s uh that’s a Navy term, you know, is that so it’s the going to where the work actually happens. So kind of, can you give us like an idea, like, you know, deck plate? So explain that a little bit.

Dr. Edward M. Daniel: So deck plate leadership is is what it is. And so there used to be when you’re on a ship and you you’re looking down where the work is happening, whether it’s on the flight deck or you’re underneath the flight deck and you’re preparing the planes to take off, or whether you’re in the mess hall cleaning, someone supervisor is always looking down at the deck plate to where work is happening. And every now and then, what you want to see is let’s say you have the officer or you have the chief or the senior leader who’s overlooking that deck plate. You see their hats being worn in the midst of all the other uh uh subordinate hats. And that’s what deck plate leadership is when you can look down from the deck plate and you can see leaders interacting on a day-to-day as things are moving in real time with the subordinates, not just sitting back watching things happen.

They are actually in the moment of while things are happening. And so you get you you really get to train a lot better. You get to do so much more with with your uh with your uh cohorts when you’re on the deck plate with them, rubbing shoulder to shoulder in the foxhole. Um, that’s where leadership actually begins because so much happens there. So much trust is built there.

Melissa Gilkes-Smith: So I think that this, I think this quote was uh was you. So you cannot lead what you cannot see. And in healthcare, what you cannot see is almost always what the patient is feeling. And that’s just such a precise statement. So, because so much of what determines how the patient experiences the hallway, the waiting room, you know, their their visit, um, the moment before the provider walks in, a leader who is only in meetings never sees those those spaces. What do you actually observe when you walk the floor that you would never learn from a report or a dashboard?

Dr. Edward M. Daniel: So I I think you you you you you hit the nail right on the head. Um I you I mean, if you just take two steps back, I can tell you any day while I’m sitting in an emergency room uh for any reason and uh and I’m looking across, um, you can tell whether or not the patients are greeted warmly. Um you can tell the staff’s body language. Are they tired? Are they, you know, have have they reached that that moment where they need a break and no one has told them, hey, go take a break, a quick five minutes and come back, because they need that to relieve that stress. Confusion at the check-in desk. That’s another big one. Um a lot of times you can you can feel that coming from that front, that check-in desk.

Uh, the environment of care, the cleanliness of that waiting room, of that ER waiting room. You could tell that the tables hadn’t been wiped down. There’s paper all over the place, band-aids and bandages and blood. And you’re like, when is housekeeping going to come down here and give some attention to this area? Um, the tone of the communication could be also a big one, where you can see the interactions between uh people, whether they are patient-patient or it’s patients and the staff. That communication, that tone could get really rough at times. And a leader has to be in tune with what’s going on in that emergency room. Um, I can even go to the families. Um, where you see a family is very, very frustrated.

They hadn’t been attended to. The doctor spoke 30 minutes to an hour ago. No one ever came back and said, hey, um, we’re it’s gonna be a little longer. We’re backed up, we had a case, whatever happened, ambulances was coming to the ambulance bay, and we, the beds got filled really, really quickly, so the weight’s gonna be longer. You need that interaction. But if a leader is not present to see what’s going on at the deck plate, and again, every go again, that your emergency room, that waiting room is the deck plate. You can’t, you’ll never be able to tell whether or not your staff is being overwhelmed, whether or not they’re understaffed, whether or not they don’t have, they may not have the supplies they need.

But as a leader, if you’re in that position, you’re able to call other floors and bring support down, and they would, they would love it. It’s not all about, hey, I gave them a bonus, I’m gonna give you a day off. Sometimes you just need to relieve the stress at the point of the tension. And so a lot of times an emergency room, and that was a good example used by being in a waiting room, um, that waiting room can be the place where the leader is needed most often.

Melissa Gilkes-Smith: So let’s go to staff that you you just you brought up uh several points about staff, you know, frustration, overwhelm, communication. So let’s talk about the effect on staff because I really think that this is where the culture of care connection is kind of most direct. Um, when a leader walks the floor consistently and genuinely, what changes for the people doing the work?

Dr. Edward M. Daniel: So I I can tell you, because I’ve been on both sides, and I think that’s that’s that’s that’s another really good trait. You sometimes you in order to be the military’s number one quote is this in order to be an effective leader, you must first be a follower. So by following, you learn the the things that when you become that leader not to do. Motivation immediately erodes um how the your care. Your care is eroded because you start to feel like leadership doesn’t care, so why should I? Um Leadership is only checking the box. They come around every hour and hour doing purposeful rounding uh on the hour. That’s not really the purpose of purposeful rounding. Um, the leader is not engaged. Does the leader know my name?

That that is a really big telltale. You work every day, you work 40 hours of work week, sometimes 60 hours weeks, and the leader doesn’t know your name. So they’re not engaged. And when somebody can’t even remember your name, and more than likely you know their first and last name and their credentials behind their name, that that erodes the morale of the organization. That erodes the culture of the organization. That kind of leadership, that kind of leader, you really, you really want to weed out because it can really deteriorate the morale very, very quickly. I mean, imagine a young person fresh out of the school, and they’re excited to get into their career, whether it’s a doctor, a nurse, or technician, they’re excited to get into this trade, and then you have a you have some a leader who comes through and just demoralize them that, you know, that’s not my job.

That’s beneath me to do. That’s the feeling you get when when leaders treat you that way. And maybe it’s not intentional. Maybe they feel sometimes, hey, I did my part. I’ve done that already, I’ve done the deck plate. Now I’m the supervisor. And they quickly forget how it felt to be that person who the leader walks past. And do you need gloves? What do you need? And they continue walking. And they really didn’t care. They just, they, they gave you some lip service and moved on. That’s very, very hard for a for a front a frontline worker to hear from a leader.

Melissa Gilkes-Smith: I um I despise that statement. That’s not my job. From a leader, when I worked at the hospital, one of the things that she always taught us was, and she would always say, Melissa, don’t ever forget where you came from. And, you know, I came from that front desk, I came from that call center, I came from every position that I had before this one. And so I’ve done all those jobs and I can still do all those jobs. Yes. I might not be as quick as I once was. It’s not a longer muscle memory, but I’ll get in there and figure it out, right?

Dr. Edward M. Daniel: Yes, yes. I’ve worked with you. I can say for I can say for sure you do.

Melissa Gilkes-Smith: So there’s a specific dynamic I want to name. So it’s the difference between a leader who walks the floor to catch problems and one who walks the floor to understand and support. So staff, they read that difference immediately. How do you show up in a way that signals the second, the understanding and support and not the first?

Dr. Edward M. Daniel: Again, I I really believe that um if if you only see if you only see a leader when things go wrong, uh leadership becomes more associated with uh with anxiety and not support. And so if you if you want to show someone that you care, you ask them, what is your name? And you remember it. Um when they give you something, when they tell you, hey, these are the issues I’m having, listen and respond, and provide feedback. Um, what do you need from a leader? What do you need from me? What can I do for you? And it has to be genuine and has to come from a place of care, not from a place of checking the box. People are so in tune to do you care? You know, a lot of the hospitals right now, that’s their quote is I care, we care.

We it’s all about care. Do you really? Or are you just wearing the badge? And that’s the thing. Uh we a leader must check in with themselves. You have to take a long look inward. Are you really living up to the values? Are you really living up to the culture that you say you’re upholding?

Melissa Gilkes-Smith: So I want to bring the patient into this conversation now because the episode is ultimately about the patient experience. So what does leadership presence do for patients? And what does a patient experience differently in an organization where the leadership is visible and engaged?

Dr. Edward M. Daniel: So from a patient’s perspective, everyone in the hospital is a doctor. So except that one in the suit. That’s the leader. When that leader walks into the room, it’s it’s not a clinician, and they know it’s not a clinician. When that and I’m gonna, I gotta stress it again. When that leader walks in the room, they genuinely care. When they have empathy and sympathy for what the patient is going through, whether it’s, hey, my I didn’t get a dessert last night, it’s something that small that can make the biggest difference. Because a leader can pick up the phone and say, I need a dessert here now. Whether it’s a kid who’s on a burn unit and they’re they’re dealing with so many emotions that they’ve never witnessed before.

And that leader can connect and say, What do you want? I want my friend’s bed next to mine. And you the leader say, make it happen. We can move beds, we can do things. A leader can do certain things that most people cannot. And able to see things that maybe the physician is focused on the outcome. Maybe the nurse is focused on the medication, the treatment plan. That person who is not engaged in the actual day-to-day making this patient better can see from a human perspective, what can I do for you that make your experience here a little better? And I think that’s where the leader and the patient’s relationship is really one because it just it just it’s a different presence of that CEO, the COO, the executive that walks in, that have the ability to move mountains when a patient needs it most.

Melissa Gilkes-Smith: So that image, going back to the image of the the leader in the waiting room, um, is kind of where I want to linger on a little bit because I think a lot of healthcare executives, the waiting room is not a space that they ever occupy. They’re in the offices, conference rooms, strategy meetings. And I get it, there’s there’s a meeting about the meeting sometime, you know? Um and the patient in that chair is, you know, sometimes entirely invisible to them. So, what would change if every healthcare leader spent 30 minutes a week sitting in their own waiting room just as an observer at Serber?

Dr. Edward M. Daniel: Well, number one, the patient’s scores will go up. You know, every leader is concerned with those uh those HCAP scores uh because it’s connected to pay. It’s connected with how you get out of the hospital to get reimbursed. Um it’s almost right now we’re at a point, thanks to the way the system is set up now, where you have to be totally concerned with the patient experience. So any leader who do not give that 30 minutes of attention to the emergency room or the critical areas that are uh bottlenecks or the areas that are overrun, overstapped, and um, the leader who does not give those places, or let’s the unit that has the beeping noise that keeps the patient awake throughout the night. Um, that that also is another hit toward the HCAP scores.

The person who doesn’t give the the correct uh discharge instructions and the patient returns with within more less than 30 days. You got to readmit. So the leader who is not engaged, number one, loses financially. It is what it is. And the scores will show on your HCAP scores. Um, but also that leader loses when it comes to the patient, because the patient has a choice. And most leaders understand that who are in tune. The patient has a choice. Your facility is not the only facility. And if you are the only facility, then you should definitely not take it for granted that they chose that they didn’t, no one in that hospital except when someone’s having a Baby is coming into that organ that facility for fun or a happy, joyous occasion.

Normally you’re going in there because you absolutely have to. And the leader that understands that understands the patient.

Melissa Gilkes-Smith: I like that. I like that. So patient-centered services, let’s go there, is built around a specific mission, staffing in-home senior care, workforce development, community impact. That’s a range of work that is deeply connected with the human side of healthcare. How does the culture of care principle show up in the work that you’re building there?

Dr. Edward M. Daniel: It starts with me. That’s so I have a vision, and my vision is to make patients, put patient at the center of everything we do. And it starts with me. When I put the patients in the center, whether it’s this is, it’s not my mom, but I’m going to treat everyone’s mom like it’s my mom or my family, my father, my child. I put every patient at the center of everything we do. So whether it’s a nonprofit, my nonprofit, where we’re giving back to people who can’t afford their copays or they can’t afford walkers or diapers, simple things that people cannot afford. Our nonprofit takes care of. We try to give back to the community. In the home care sense, we spend quite a bit of time in training to get our employees trained and up to speed.

And then we take it one step further. Well, we do training in the home with the patient because every environment is different. We have an RNA that goes in and does that kind of work. Again, the patient is at the center. We want to make sure you feel as though you are at the center of everything we do. And so even when it comes to staffing, the right person, the right fit, most of the time what we do is we tell the client, whether it’s a hospital or a senior living home or a SNF, we say, hey, listen, please, let, please interview our patient, our staff and make sure it’s a good fit. If the staff is not a good fit, we move the staff somewhere else. Everyone is not a good fit for every situation.

It’s not just, oh, I have the skill. Sometimes you’re not a good fit for it. And so we take very, very, very much care and making sure that we keep the patient experience at the center of everything we do. So it starts with me. I I set up systems and processes to where the patient is always at the center of everything we do. And that flows down all the way through to whether we’re doing behavior health, janitorial services in uh in Rico, Virginia. Um, we’re still patients are at the center of what we do. We have to bring the level of cleanliness up in those facilities, just as though the physician that we that we uh hire to do his job as well uh with patients, make sure that they are credentialed.

They don’t have the backgrounds and they don’t carry the liability because they don’t have the temperament to see patients uh or see a certain type of patient. So making sure that everybody’s a good fit and that we are giving excellent care is what we do at all times. And it starts with me.

Melissa Gilkes-Smith: So you just had a big community impact event um this past weekend, you know?

Dr. Edward M. Daniel: Um, I just want to say I had fun.

Melissa Gilkes-Smith: You had fun.

Dr. Edward M. Daniel: I had so much fun. Um next year I’m gonna work CAPE. I’m gonna be the home care hero. Uh I think I’m gonna I’m gonna do a whole deal around I’m the home care he home to a home care hero uh because right now post-secured care needs a hero. And why why not me? Why can’t I be but we had a wonderful time. We raised uh over $60,000 this time. Our first time out. Um it was it was uh it was a long road, but it was so worth it. We already have many, many people who are in line right now and have applications in to meet their needs. And like I said, it whether it’s uh we had lots of people who donated food, we had people who donated the diapers for adults, we had people who donated wheelchairs and walkers, and so we would and we and then people gave it in kind.

And then, oh, I gotta mention uh visiting angels of Manassas came through for us in a big way financially. Uh also uh uh what was it, Sam’s. We had Sam Club uh donated a television that we were able to give away, and they donated a PS5 that we were able to give away. Um so we we had we had we had uh Central uh Fidelity. Uh Central Fidelity was a uh facility that gave us donations that were pretty large and made a big difference, a big impact right away. So we had a lot of people who came together, not just the community, but also uh corporate responsible people joined us as well, organizations to make it such a success. So we’re really, really excited about uh how that day went. And we are looking forward to uh June, July doing this again.

Um wonderful, wonderful time. This this actually gives me purpose. Um, you know, for profit, you gotta watch the bottom line. Yeah, it’s it is what it is. Nonprofit, you’re just making somebody’s day a little better. Every dollar makes a day a little better. And so we’re we’re gonna continue to do this work, and I think that’s what my purpose is. And I’m gonna continue to spend time in that vein.

Melissa Gilkes-Smith: I uh I look forward to next year. Next year I’ll come see your purpose in motion with your cape.

Dr. Edward M. Daniel: I’m sorry, it’s gonna be on. It’s gonna be on. You’re gonna see it. I’ll be I’ll be flying around there somewhere trying to make a difference.

Melissa Gilkes-Smith: So um I want to speak directly to the healthcare leaders listening, the practice owners, the COOs, the department directors, the charge nurses who are also leading teams. So for the leader who has been mostly behind a desk, who knows they should be more present, but doesn’t know actually what that looks like in practice, where do they start?

Dr. Edward M. Daniel: Where do a leader start to build on if they’re you mean if they’re not currently doing anything at all?

Melissa Gilkes-Smith: If they’re not, if they’re not doing, if they’re not using the management by walking around, how do they how do they get started, you know, being visible, being more present, you know, getting out of their office? I know it’s easy to just say, well, just just go. Just do it.

Dr. Edward M. Daniel: Just so it is. It’s that’s it’s as simple as that. Start small and be consistent. That’s what I would say. Start out small. You you don’t have to make big splashes in the in the pond. Start small and just be consistent. Schedule your time weekly to walk around. Um it you you it it has to be intentional. Get your mind right. When it’s time to do that, walk around, say, okay, I’m I know what my purpose is and know why I’m doing it. Center yourself and then walk with purpose. Um don’t arrive when things are going chaotic. That that’s the worst time to show up in an area is when things are going just bizarre. They don’t need, it’s like the president showing up in the middle of a storm. You you you take away resources because people need to attend to the leader who just walked into the room.

Coming in when it’s calm, when things are going well. They just make a cadence of consistently walking through. Ask and ask questions. Don’t give speeches. Uh grandstanding is the worst. People like here we go again or here she goes again, they don’t need it. They don’t need it and they don’t want it. Um I’ll have to reiterate this several times. Learn people’s names. That’s probably the biggest thing you can do is call them by their name. There’s something about it that just when a leader says your name, they know you, they see you. And then um follow up at least, um, at least on one issue. Every time, follow up at least on one issue. Even if you can’t resolve that issue, say, hey, I just want to let you know, I remember you told me last time this was happening, I’m working on it, or I, you know, we fixed that.

Just at least one thing, follow up on that. And that’ll make the difference. You know, there was a story about uh a guy that was uh that uh that was throwing these uh these fit these starfish back into the water. And uh it was called the starfish story. And there were so many of the starfish that were on the beach, and he asked them, he said, you you there’s no way you could throw all these starfish back into the ocean before they die. Um you you you can’t make an impact. And and and what struck me is when the fella picked up another starfish, he threw it out into the ocean. And he said, it made a difference to that one. And that mattered. And that’s the thing. If you can make a difference every time you make a round to one person, you’ve done your job.

And I think that’s what it’s all about.

Melissa Gilkes-Smith: So what about when if you start this practice or for leaders who have already tried and they’ve gotten some resistance, the staff seem to feel a little bit uncomfortable, they’ve like lived in a culture where you know the leadership presence, you know, reads kind of surveillance. How do you rebuild that trust?

Dr. Edward M. Daniel: It’s the second part of that. What what we did what I was just speaking about um be consistent. If it didn’t it didn’t change overnight, uh, it’s not gonna change overnight. That the mountain of lies and uh I want to call it lies. Sometimes it’s not a lie, it’s hope. You kept giving hope, you kept giving hope, you kept getting let down. The mountain that was created, it’s gonna take the same amount of time to knock that mountain down. But be consistent. And and and that’s the thing. Like I’m gonna continue every day to make strides. And we’re gonna go back there again. If you can make a difference to one, that one person may tell somebody else. Although the rest of these leaders don’t care, that one does.

That one does.

Melissa Gilkes-Smith: That one might be your champion.

Dr. Edward M. Daniel: Right. And that that’s the one that that that made your day. And so if you can get one, it it becomes infectious. And that’s what you need. That’s where it starts.

Melissa Gilkes-Smith: So, last question. The last 25 years of leading healthcare, what is the one single moment of walking the floor that has stayed with you, the one that reminded you why this practice matters? Why does walking around matter?

Dr. Edward M. Daniel: You know, the worst period ever is COVID. COVID brought out the best and the worst of everybody in healthcare. I saw nurses um burn out. I saw doctors burn out. I saw patients hysterical. Um, we were all worried because nobody knew what was going on. I saw leaders leading. At one facility in particular, it was um atrium health. Um a leader, a good friend of mine too, Roy Hawkins. Um, he was uh he was he was at an organiz not atrium, he was at uh a hospital in Florida. He was at uh Jackson Memorial Hospital in Florida at that time, the CEO. And COVID hit, and he stayed. He stayed right there. And I think seeing him walking around consistently with his staff, constantly, you know, we were all trying to lock down and didn’t want to touch and didn’t want to breathe on each other, didn’t want to come six feet, you know, and CDC set.

I saw this leader, this executive walking around when it mattered. When when everybody else was afraid, it’s almost like the the fireman who runs into the fire where everybody else is running out of it. I saw an executive, I saw a leader leading from the front. And in the military, we call that leading from the tip of the spear. You’re the first one in. And this this leader led from the tip of the spear. And it encourages me that we are that there are leaders out there that care enough to lead.

Melissa Gilkes-Smith: So I appreciate you sharing that. Um, you brought to this conversation, uh, what you brought to this conversation is something that I think a lot of healthcare leaders feel but struggle to name. Um the culture is not what we say we believe, it’s what we do consistently. It is an act of accountability, of compassion, of empathy, of collaboration. And this is the culture of care made physical, the management by walking around. When a leader walks the floor, they’re saying without a single word that this work matters, these people matter, that the patient in that chair matters enough for me to be here, paying attention, and the staff feel it, the patients feel that. And that’s when the culture is built, I think, really in those moments.

And before I let you go, what do you want every healthcare listening to carry away from this conversation? Make a difference. One patient, one staff member at a time. Make a difference. It is your job, it is your charge. It is, I hope, is why you became a leader.

Dr. Edward M. Daniel: You know, there’s a saying if you are leading and you look behind you, no one’s following you, you’re not a leader. But if you are leading and there are lots of people behind you, then you owe it to them to be the kind of leader that shows compassion and care in everything you do. So I would say show compassion and care and be consistent. That’s three C’s. Compassion, care, and consistent, always.

Melissa Gilkes-Smith: Thank you so much for taking the time today. Um, I want to thank you for your service, for your leadership, and for bringing 25 years of hard-won perspective to this conversation. Oh, it’s not so bad. And for you know, our listeners, the challenge this week is very simple. So get off the floor you’re usually on, walk somewhere in your organization you don’t normally go, sit in the waiting room for 20 minutes, stand at the front desk, and just watch what happens. Don’t fix anything, don’t comment at anything, stand back, sit back, observe. Because you cannot lead from what you cannot see. And you can and what you see this week might change everything about how you lead next week. Well said. Well said.

Thank you, Melissa, for having me. Thank you very much.