By Candace Beeke
– Publisher, Albuquerque Business First
Jul 31, 2020, 7:00am MDT
Updated Jul 31, 2020, 11:21am MDT
This story has been updated to reflect the number of employees at Christus St. Vincent that have been brought back from furlough.
Lillian Montoya hasn't always been about health care, but her career has always been about leadership. This is a woman who uses the word "team" as a verb.
Prior to becoming CEO in 2018 of Christus St. Vincent, the largest healthcare provider in Santa Fe, Montoya's career included leadership roles across multiple industries. For seven years, she was deputy director of the New Mexico Commission on Higher Education, and later, she was program director for the New Mexico Early Childhood Development Partnership. She ran the Community Programs Office at Los Alamos National Laboratories for three years. She worked in finance and venture capital for a number of years.
She officially began working with Christus St. Vincent when she joined its board in 2010. In less than three years, she gave up her board seat to take on the role of vice president for public policy and stakeholder engagement at the hospital. She worked her way up over the next five years to chief administrative officer, COO and finally, CEO and president.
During the Covid-19 pandemic, Albuquerque Business First reported Christus St. Vincent furloughed around 300 employees.
“We received free and clear $8.8 million from the CARES Act. Pre-Covid, my payroll was $7 million per pay period. While incredibly helpful, the $8.8 million buys me payroll and a half after I put people on leave,” Montoya said about furloughing employees.
Montoya said by the end of July, 75% of those furloughed had been brought back to work.
I sat down with Montoya to discuss her leadership journey and how those skills have been tested during the Covid-19 pandemic as part of my continuing series on executive leadership.
Tell me how the past few months have been for you.
This has really been a test of leadership for me and our executive team and our leadership team. It's had some very challenging moments and some really inspiring moments where people have leaned in and done amazing work. We've learned a lot about our organization and how our transformation has allowed us to be as nimble as we've been in the last few months. I think had this pandemic happened three or four years ago, we wouldn't have responded as strong and thoughtfully and compassionately as we have.
It's been hard. We've had to make some tough decisions. However, our folks have really demonstrated why they are in health care and why they care for their community and how they care for their community. I'm so inspired by our people.
What are some of the changes you've had to implement because of Covid-19?
From a facility standpoint, we created a space that segregated our Covid-positive patients from the general patient population. We also asked for care team volunteers to care for that patient population. We call them our superheroes.
On top of all of that, we need to manage financials. Our volumes were tanking because public health orders encouraged people to isolate at home, which was absolutely the right thing to do, but that meant they weren't coming to a clinic or the hospital. And then people were coming eventually to the clinic or the hospital, but their conditions were far worse because they isolated too long because they were fearful of coming to the hospital or the clinics thinking they would get the virus.
Then my associates go home and their family members have been watching the national news all day, and they're worried that their loved one is going to get the virus, so we're straddling all of that, while at the same time creating and ensuring there was enthusiasm for the work we were doing and that we were still staying connected. So it was meeting a lot of emotional needs in a relatively short period of time and having to put communication on steroids really quickly.
Tell me about the stress your team has felt and how you've been able to help them deal with that.
There are different kinds of stress in this environment. There's the stress of job security. There's the stress of getting the virus. There's the stress of watching patients die at a rate you hadn't experienced before. There's the stress of going home and having to ensure your family feels you were safe. The first thing we've done is acknowledge those stresses and talk about them in our virtual town halls and safety huddles, and when we're doing rounds in the hospital, we check in on our associates. We ask them, "How are you doing?" And actually having the conversation where there's nothing off the table. I continue to round — I go in on the weekends to see how people are doing because 50% of the win is showing up and people knowing that you're showing up.
The other things that we're doing on a very real-time basis is getting feedback from the care teams that are caring for our Covid-positive patients. They want to make all of the discharge follow-up phone calls to the patient themselves, they want to call the families and have a conversation with them if they lost a family member. They want to own that relationship as part of what they did as a caregiver.
In addition to that, we have our spiritual care team that has been creating space for meditation moments — safe spaces for people to decompress. We have a daily prayer that's announced midday so people can pause and reflect. They don't have to pray but they can reflect or meditate or just take the time to appreciate the moment we're all in and in caring for each other and our community.
We celebrate their successes. Each time we've had a discharge from the hospital of a Covid-positive patient, we have the equivalent of a parade. Everyone is masked and socially distanced, and we all have these little instruments and we're celebrating the patient, but we're also celebrating each other because that whole team has a lot to do with it.
This community has leaned in — the restaurants have leaned in by providing meals to many shifts of workers for the entire pandemic. And it's made them cry. It's gone a long way because my people feel supported, they feel loved, they feel appreciated, they don't feel taken for granted. The community has placed signs at the entrances. The kids have made signs that we posted at all of the time clocks. They are definitely feeling the love and that helps with the emotional toll of this entire experience — knowing that other people are bearing witness to your experience.
How have you managed your own stress through this?
It's doing my best to still exercise. It's doing my best to have my quiet time where I don't want to be nibbled on. I want to get home even if it's nine o'clock at night and just be in the quiet and reflect on the day and listen to loud music, and go in the yard and work in the garden and just try to be someone else for a minute just to catch my breath. But it's also being with my team — our leadership team has an amazing sense of humor, which has been a key ingredient to being able to ride this wave. And we can laugh about things still and keep each other's spirits up and be the safe space to have conversations. It's really important to lean on other people who are on the same journey because they get where you're going.
Christus has been named a Best Place to Work for the past three years. Very few hospitals achieve this honor nationally. Tell me about your culture and how you have helped create a Best Place to Work.
Let me start by saying I was blown away that we earned the Best Place to Work in the middle of a pandemic. It said a lot about how we truly are engaging with our workforce. It means that we've been honoring our commitment to create an environment that allows our people to do their best work. And that we're continuing to bring down barriers so they can feel safe and supported and we have created ways in which we continue to communicate, keep people informed, but also be available to receive feedback.
In the last year and a half, our saying is that feedback is a gift and how you receive the gift is a demonstration of your willingness to learn how we can be better. I'm more convinced than ever that we're doing the right things for the right reasons. We're not perfect, but the commitment is really real to take care of our people. And they contribute more and at higher levels because they feel celebrated and supported.
What has changed in your industry because of the pandemic?
It has led to a much greater, deeper collaboration with other health systems that are our competition. Being able to actively collaborate with Lovelace and Presbyterian and UNMHSC but also Los Alamos and Holy Cross and our hospitals in Northern New Mexico. We're sharing policies, we're sharing ideas, we're sharing strategies on how to care for a population that has the virus. We've had to get to trust really fast, and get to know each other as human beings and professionals. It's been really rewarding.
How has your partnership with Mayo Clinic helped during this time?
Very early on, our relationship with the Mayo Clinic allowed us to have access to tests so we could get a 45-minute turnaround to determine whether or not someone has the virus. Elsewhere, it was still 24 to 72 hours in some cases, just because of backlogs if you went to some of the New Mexico labs. The other huge benefit was that we were able to lean on Mayo for the convalescent plasma as a therapy for those who have Covid-positive status. By bringing together Christus Health and Mayo, we were able to get into that trial pretty quickly, and other hospitals in the state were a good two to three weeks after Santa Fe.
Where do you see yourself and the business in five years?
I'm confident in our ability to remain a strong, healthy organization. We're focused on doing many of the right things to care for our community and where we need to grow volumes in business. I'm probably more optimistic than most in health care, but I know what's possible based on where we have expertise and resources. And we have a team that's pretty bold. So I think we'll be more than our pre-Covid numbers of 2,200 employees.
What's the best business advice you've ever been given?
Before I even was in health care, the best advice I ever was given was, "Treat every opportunity as if it's your business. Be the CEO of your department, be the CEO of your team." That sets the standard for what you expect and the vision you're creating about what's possible.
What's the best business advice you give others?
Focus on people. And it's so many levels of that, too, because for me, it means listening to all the gifts of feedback from my executive team and from leaders that may be seeing a side of the organization that I'm missing. They have advice, they have a recommendation, they have an opinion about a missed opportunity — a way to fine tune something. It means being open to that and receiving that information and knowing you need to rely on the wisdom of peers to have really amazing results.
Where could you improve as a leader?
I think every human struggles with, "Don't take things personally." My everyday reflection is, Was it truly personal? I'd rather be respected than feared, so if someone touches a nerve, maybe I fell short a little bit and I need to figure out how I could have done that a little bit differently or a little bit better.
I will end nearly every conversation with any member of my team saying, "How could I have done that better?" Or I will say, "What can I do right now to be helpful to something you're trying to accomplish?" In the last month, we've had to have some very difficult conversations with people. When I'm one on one with my team members, I'll say, "Maybe that didn't go as well as I would have liked. How could I have said something different? Did I set the right tone? Is there something I was missing?"
I think I have really created a habit around feedback. And I will receive it as long as it's graciously delivered. Everyone wants feedback graciously delivered and people [who don't] come at you with that are just not communicating in a kind way. You're not going to receive the feedback. But when it's graciously conveyed, and it's with compassion and desire to do our best work, people will feel comfortable sharing. But you have to demonstrate that you're comfortable receiving.
What would you never want to see change about New Mexico and what would you like to see change about New Mexico?
New Mexico feels like a big family to me. And like many families, there's some members that drive me crazy and there's some members you just love, but it's mostly not personal. I think it's the benefit of being kind of small. That's why I've chosen to stay in New Mexico. I could have gone out of state.
I think that we still have too many people that haven't realized their possibility and how they can contribute to our communities and places they work. I think we have a tendency to write people off if they don't measure up to what we want, but we haven't adequately communicated or created opportunities for people to realize that possibility. We have a lot of talent that's underutilized in our state. I think it's why people choose to leave the state. I think it's why young people think they need to find their dream somewhere else. I think it's why it's hard to bring my kids back. They need to know that they could be part of the fabric of what New Mexico looks like next. And we aren't creating opportunity to have more people at the table to help be part of that.