David Novak 0:04 

Welcome to How leaders lead where every week you get to listen in while I interview some of the very best leaders in the world, I break down the key learning so that by the end of the episode, you'll have something simple you can apply as you develop into a better leader. That's what this podcast is all about. Today's guest is Madeline Bell, President and CEO of the world renowned Children's Hospital of Philadelphia. Now, you've probably heard me talk about how important it is for leaders to walk the talk for our actions to sync up with our words. Because to be honest, our people are only listening to us some of the time, but they're watching us all the time. What's our tone, our body language? Do we listen? Do we take time off to balance our lives? Sure, that kind of visibility can be a lot of pressure. But it's also a huge opportunity to model the behaviors we want to see more out of our team. And a lot of us miss that opportunity. But Madeline sure the heck doesn't. She knows how powerful her own behavior is for setting the tone at her hospital, she recognizes that people watch her, and that that visibility is an opportunity for her to shape a stronger culture. And it's helped guide her team through a global pandemic. She's dealt with staff exhaustion, financial strain and rapidly shifting information. And she's still been a champion for the incredible medical innovation the Children's Hospital of Philadelphia is known for. So let's dive in and see how she does it. And how we can also build stronger teams simply by modeling the right behaviors for him. So here's my conversation with my good friend, and soon to be yours, Madeline Bell.

Madeline, I want to thank you so much for taking the time to be with us. I'm thrilled to be here. You know, Madeline is as we move into 2021 How do you think the vaccine is going to impact our COVID-19 life? And and what should we expect?

Madeline Bell 2:00 

Well, I'm so pleased to see that we've got two maybe three options and more to come for different vaccines, um, you know, a Children's Hospital of Philadelphia, we have a very long history of developing vaccines, and I've never seen anything go this quickly. And frankly, you know, the recent searches of of, of the pandemic have actually helped propel the clinical trials faster. So I'm excited about it. It's certainly daunting, because the distribution, logistics need to be worked through, but it's all I think, good news.

David Novak 2:40 

Yeah, fantastic, you know, and this vaccine is the product of project warp speed. And how much does the speed the market concern you Madeline?

Madeline Bell 2:51 

Well, it would concern me if I thought corners were cut. But I don't believe that corners were cut, I believe there were a lot of good people who are involved at every level, and, you know, really are watching very closely, following all those safety guidelines. And so I'm, I'm not concerned about it. And I think we have a lot of education to do with the general public. Because there's lots of misinformation or just information out there. That's it's unclear. We were even trying to vaccinate children with flu vaccine. And families are saying, Well, I'm not, I'm not ready to take that COVID 19 vaccine. So it leads me to understand that, that there's just a lot of confusion about the vaccine.

David Novak 3:37 

How do you plan on implementing the vaccine with your doctors and your frontline workers?

Madeline Bell 3:42 

So we've made a priority cred for those doctors and nurses and environmental service workers and supply chain people who are working on our two different COVID-19 inpatient units, they will be offered the vaccine first people in the emergency department, you know, and we have a whole a whole priority scheme of how to distribute the vaccine,

David Novak 4:07 

you know, stepping back and just thinking about what's occurred in 2020. What do you think will be the long term impact of the COVID 19 disease and and how, how it will impact our lives over the longer term?

Madeline Bell 4:22 

Well, I think there are a lot of changes that will come in terms of how we how we work and how we prepare, you know, I've spent decades of my career preparing for a pandemic. I mean, most people don't didn't even know what was the difference between an epidemic and a pandemic. And so, you know, for me, we've been doing tabletop exercises, for this type of thing for years, and it was beyond anything we ever prepared for, frankly, but I think we will all step back and learn so many lessons from this pandemic, those of us in health care and And those of us in other industries,

David Novak 5:03 

do you think that masks will become a way of life in the United States?

Madeline Bell 5:08 

I believe so for certain people, I think for certain people who are, you know, more immunocompromised, or maybe older folks. You know, masks are now becoming a fashion statement with all kinds of, you know, different sayings and patterns. I remember saying to somebody, you know, I would see, I've been to Asia, and I know you have to, and I would see, you know, people with masks and sort of seemed curious and like overkill to me. And now I sort of get it. Given the original SARS epidemic in Asia, you know, I think we all have a better understanding. So I do think it'll become, you know, just more of an accepted thing for people to do.

David Novak 5:53 

You know, it's, as an aside, you talk about baths being a fashion statement by my grandkids gave me you know, masks that were specially designed with my grandfather name of Oh, go on it, you know, do you have a specific mask that really, you wear when you're stepping out?

Madeline Bell 6:12 

On my favorite mask is the one was the chop the Children's Hospital Philadelphia chop logo on it, and our our chief of cardiac surgery, heart surgery, I gave it to me, and he had it made on Etsy. So I love that mask, chopped Cardiac Center on it, it's my favorite.

David Novak 6:29 

Yeah, true blue to the very end. You know, as you know, this podcast is all about how how leaders lead. And I want to focus in on how you have inspired your team in these uncertain times we've all gone through, you know, this is really tough stuff. Why is it so hard to do?

Madeline Bell 6:49 

Well, I think that it's so easy to lead during good times. And we don't even sort of think about that. But in times of crisis, we have to be really thoughtful, and planful. And we sometimes have to develop new muscles. You know, I would say that the new muscle I developed was feeling comfortable with saying the term the statement, I don't know. Because I always felt like I was the CEO, I had to have every answer for every scenario. And we've been doing twice a week town meetings and really communicating a lot. I've been actually going on the front lines, and talking with people with my PPE on. But I, I, I got comfortable for the first time in my career, really saying the words I don't know. But then following up to say, but here are the three things that need to be in place for me to know. And so I think that it's it's hard. So I've developed new muscles as a leader through this pandemic,

David Novak 7:48 

what advice would you give people on on how to get that into that comfort zone of being able to say, I don't know?

Madeline Bell 7:56 

Yeah, I do think I do think that sometimes, we as leaders feel like we need to be infallible. And I think it's a matter of, you know, making people realize that there is a vulnerability and being the CEO or being the leader, and that's okay. And sometimes it makes you much more relatable to people if you are vulnerable, you know, they don't really want to know the answers. They just want to know, you know, how the answers are going to come? What's the timeline? So I would say to people, I don't have an answer on that, I really don't know. But this will, I will know, in three, three weeks. And here are the things that have to be in place for me to know and it just calm people down, even though I wasn't giving them the answer. And I think leaders have to just get, you know, become okay with that.

David Novak 8:45 

So if you don't have the answer, then being clear about the process you're going to use to go about getting one is really big, the key is to understand that yeah, you know, there's so many facts that have been flying around the COVID-19. You know, how have you managed the facts that are out there?

Madeline Bell 9:04 

Yeah, you know, it's interesting, I work with, largely with a group of scientists. And so, you know, early in the pandemic, you know, I realized that I was hitting them with the facts, you know, all of the facts about how it's transmitted, and how to treat it. And I realized that that was not working. And so it's really not about the facts. It's really about recognizing that, yes, you should give people the facts. But that is just not enough. You have to follow it up with listening and understanding that people are frightened, and that you have to, you know, understand that there's a lot of emotion involved in this. And people are worried about themselves and not just the patients say cared for but keeping themselves safe and many of many of them haven't faced that in their careers. So I realized that it was much more about support, supporting people emotional Lee, and being a good listener, than it was just hitting them with the facts.

David Novak 10:04 

So how do you go about helping your people understand the feelings that they're going through? You know, and we all have, you know, these feelings that we've never experienced before, just because what's happened is never happened to us before.

Madeline Bell 10:17 

Yeah, I think it's giving people the space and time to process through it. And and sometimes in small groups of people talking through what does this feel like, which, you know, for some tough surgeons, they're not used to that. And it's, it's, it is those same people who are not used to sharing their concerns or their feelings that we need to really we need it to say, you know, this is okay. This is really hard stuff. It's hard for me as the leader, you know, I've been saying to people continually, this has been the most challenging time of my career. And that gives people a little bit of permission to sort of let their guard down and say, you know, what, it's been really hard for me to, and so I think it's modeling that behavior of, you know, it's okay to talk about how hard this is.

David Novak 11:10 

You've mentioned communications, you've talked about your the town halls, which you do, and you talked about that very powerful message that you just mentioned, you know, you know, how have, as you've gone about communicating with your teams, what's been the biggest thing you've learned?

Madeline Bell 11:26 

Well, I do think that there are so many things. First of all, I think, frequent communication in many different using written emails, town meetings in person, I think, really important for leaders and that how do you do that? Well, you know, for me, it's a little different. I, you know, I have people that have never left the bedside or the exam room, and I need to be there, you know, to periodically check in with them to say, you know, I'm your CEO, and I'm here for you. And I know you've been on the frontlines all this time. I think that's really important. But I also think that people as, as the leader, they're constantly watching you, and watching how you're, you know, how you're reacting to all of this, the tone of voice that you're using, how Where are you are, and so, I've been really trying to show how calm I am, and I've read, titled myself from CEO to a cheap free assurance officer. And, you know, my goal is to just continually be calm and reassure people give them the space, they need to process this. But it's it's really a, it's really, as a leader taking on a very different role,

David Novak 12:43 

you know, Chief reassurance officer, I've never heard that. Is that something you internally just is that a word picture you use for your leadership?

Madeline Bell 12:50 

Yeah, I literally made that up in the midst of, you know, the first wave of the pandemic, because I felt exhausted myself, because all I was doing was trying to reassure everyone, and reassure everyone not only about their safety and the safety of our patients, but about our financial situation, we, like many hospitals lost hundreds of millions of dollars of cash flow from the pandemic. So, you know, you sort of, you're dealing with something you've never dealt with before, and you're in the midst of a financial crisis. And we're, you know, we moved 6200 people to work at home, which we had never done before, you know, we scaled up telehealth, you know, all of these things. But the place where I was spending most of my energy was just reassuring everybody, and I kept telling them, you know, let's remember what the what the British did during World War Two when they were being bombed every day and you'd wake up and you know, your neighbor's house would be gone and they would be gone to is they they they had to remain calm and carry on. And so I've been sort of saying to people, we got to stay calm, and we got to carry on, you know, so just modeling that that calm and reassuring presence I think has been very important.

David Novak 14:07 

You know, Madeline it's so easy to go from problem to problem tact a tic tac IQ, how do you how do you keep yourself out of the weeds and and keep the big picture front and center for for yourself and your people?

Madeline Bell 14:22 

I think it's a great question, Dave. Because I, I've, I'm, I'm such a proponent of making sure that I stay at the right level that I'm thinking about issues and problems that I need to solve for the next decades and not for tomorrow. And when you're in the midst of a crisis, I think as a CEO or any leader, you really need to discipline yourself to make sure that you're not just putting out fires and you're not just in the weeds. You know, a big a big one. A big, big area of focus for me is pushing decision making down to my team. And I had this Stop and discipline myself to say, you know, people have a tendency to run things up the flagpole a lot in the midst of a crisis because they want direction. And I had to continue to make sure I was pushing the decision making down reminding people. We've got to practice progress over perfection, you know, all the things that I'm always focused focused on in good times. So it's it takes discipline to make sure that you're thinking strategically, you're thinking about the future long term, and not just about how to get through the next 24 hours.

David Novak 15:36 

Did you carve out specific time to make sure that you did that? Or did you change the way you do? Do your calendar?

Madeline Bell 15:44 

Yeah, I really forced myself I have a meeting every week with my team called the CEO Council. And I really forced myself to make sure that the time that we were using together as a team was not just about, you know, the here and now today with what's happening with this pandemic, that that there were other venues for the leaders to work out those those decisions. But acknowledging and any and certainly spending time on any big picture, questions that needed to get get answered, but to really keep looking at the strategy. So we spent the entire summer pressure testing our strategy against, you know, what we learned, and we're continuing to do that in a way that that has us sort of forward thinking and not just thinking about today. You know,

David Novak 16:34 

there's no doubt that COVID is upset the applecart for almost every leader, and how do you go about dealing with the major disappointments that I'm sure you had of having your best laid plans truly disrupted?

Madeline Bell 16:50 

Yeah, I've talked to the teams of leaders about, you know, sort of making the analogy to the stages of grief, when COVID hit, we had this great strategy, we had a whole capital plan, we actually had a 10 year financial plan that sort of laid out how we're going to invest in our strategy, I was in love with it, it was great. And then COVID came, and you know, we had to pivot and we lost, you know, $260 million in cash flow, and all these things happened. And I realized that what I was really doing was going through the stages of grief, and that I just needed to let myself go through those stages, you know, that this, some of the stages of grief or anger or some or denial, you know, you and then to the point where you get to the final stage, which is acceptance. And so, you know, as a nurse, I understood the stages of grief. And so I started using those, that analogy with with the team to talk about, you know, how this, how this might feel, again, back to how it feels,

David Novak 17:58 

you know, you're such a positive person Madalyn, and I've heard you talk about the importance of looking for the silver linings, you know, how so? And how do you go about doing it.

Madeline Bell 18:11 

So I think you have to be very deliberate about it. And so I've spent time with my team, stepping back and taking stock and saying, here's all the Silver Linings that have come out of this pandemic. You know, as an example, we had a lot of excuses about why people couldn't work at home. Now of the 6200, we still have 5000 people working at home. Now, most of our people are working at the bedside or in the exam room with patients. And so now we're, you know, we I think the world is our talent market. If we can hire people that are working at home, that means I can hire people from anywhere in the United States without barriers. So that's a major silver lining for me. The other thing that we did during the pandemic, which I'm so proud of is, we went from doing about 20 telehealth visits a week to 2000 a day. And, you know, that's what happens during a crisis, it becomes the motherhood of invention. And, you know, we, we, we had all the tools we needed, we just had some cultural barriers to, you know, oh, how are we going to do this, and we figured out how to see our patients every day. And so, we have to, we are now being really deliberate to say, what did we learn about these things that we did quickly? And how can we step back and tweak them and make them you know, make them sort of the way we do our work now. And the other thing is just, you know, people did a great job of making decisions quickly, and I don't want to lose that. And so, you know, I've been calling these things out like, wow, this is let's do more of this. Even though we might be out of a crisis stage. Although right now we're we're still struggling with with a surge of the pandemic but, you know, how do we how do we make these great things last?

David Novak 20:06 

You know, you're obviously in the health care business and you're serving others and, and I know that your focus, but what do you do to make sure that you're on your A game and that you take care of yourself?

Madeline Bell 20:18 

Yeah, I think I, I talk about this a lot with my leaders because it takes discipline, frankly, it's, it's easy to work. It's seductive, it calls you when, you know, it's, especially when you're in the midst of a crisis. But I think self care is really important, and find those couple things that help you recharge and disconnect. And I've also been talking to people a lot about the pause, like, we do our best and most creative thinking is when we're sort of out of the, you know, the the day to day crisis management. So making sure that you have space and time to think and pause and become creative. And part of it is just modeling that behavior and telling people it's okay to, to take time away. And I've been deliberate about saying to people, you know, I'm taking this day off, because I need to recharge, and I think it's important for people to hear that,

David Novak 21:15 

you know, healthcare, as you know better than most is it's such a huge issue in our country. And if you were the president of the United States, Madeline, tell us how you as a leader would go about coming up with a winning solution, that would be right for our country.

Madeline Bell 21:35 

That's a certainly a challenging one. I think about this a lot, though, because health policy really matters to me. And I really love the system in Germany, the system in Germany, if I have it all correctly, but it's the each employer pays a 7% per employee, and it's matched by the government. And so the employers do sponsor health care, the, but the government does, too. So it's sort of a nice nexus of private and public funding. And that allows them to have, I think, a good pool of money. And, you know, I don't think it's good for the government to be completely prescriptive about how it works, because I do think innovation often comes in private industry. So I like the way the German system works, where you have a combination of, you know, of employers or the private market, partnering together with with the government to create a system of health care now, because I work with children. And you know, children are our future, I very much believe that we need to start investing more in children's health, in preventing diseases, giving them access to good, good health care, because that really creates a lifetime of good habits and a lifetime of health.

David Novak 23:06 

Well, you've got some really good ideas on how you would tackle this. But when it comes to like, getting everybody else on the same page and getting the right people in the room, you know, how would you go about that? Because, you know, you've got your ideas, but how would you go about galvanizing the horsepower of the United States?

Madeline Bell 23:26 

Well, I think we have such incredible talent, and I would make sure that I have people from, from multiple aspects of healthcare industry, I mean, innovation is at, I think, the core of how we're going to help solve, solve healthcare problems in the future. And, you know, bringing innovative people together to give them the license to solve some of these problems, I think, would be really important. So investing in research and innovation, bringing really good minds together, and frankly, very much bringing both sides of the aisle together politically. I think that convening people is really the best way for for us to go in terms of creating a better system and better policies for health care.

David Novak 24:13 

You know, we're moving into 2021. And what's your prediction for the state of the nation's health not only with COVID but the impact it's had on so many other diseases? You know, people always talk about people who haven't had the checkups and you know, all all the, you know, the mental issues, you know, just, you know, how do you look at the state of the nation's health?

Madeline Bell 24:37 

I'm really concerned, I think COVID has put a spotlight on multiple things. It's, it's put a spotlight on the lack of equitable care that we have in this country. It's put a spotlight on the lack of behavioral health, mental psychiatric services that are available to people. And you know, we were part of a Campaign among a lot of other hospitals called Stop medical distancing. And I also think it's created a barrier for people who are frightened or delay in, in in accessing health care. So we have a lot of work to do. I would say most of the work is in the area of ensuring better access to behavioral mental psychiatric support for everyone from children up to you know, to older folks

David Novak 25:27 

battling this, you know, it's been fascinating to hear your thoughts on this subject. And we're gonna wrap this up with a little fun with a lightning round q&a. Okay. So, first of all, what are the three words that you think best describe you?

Madeline Bell 25:44 

Enthusiastic, optimistic and driven.

David Novak 25:48 

You have any hidden talents?

Madeline Bell 25:50 

Do I have any hidden talents? Well, I love I love to cook. I don't know if that's a hidden talent. I used to love I used to love to rollerblade that was like my favorite. One of my favorite things to do. I would say my, my, my, the thing I really love right now is to paddleboard. That's probably the thing I did all summer long to recharge.

David Novak 26:13 

Great. You know, if you could be one person for a day, who would it be? And why?

Madeline Bell 26:19 

Well, I'm a big history buff. So I would love to be John Adams. i He was such a brilliant man and had such great foresight about how this country should be set up. And I wouldn't mind walking in his shoes for a day and having his wisdom.

David Novak 26:38 

He was extremely bright. No question about that. What's your biggest pet peeve?

Madeline Bell 26:43 

I you know, I would say my biggest pet peeve is people who see the glass as half empty all the time. It's just it really bothers me if that's how people lead and when I'm around people like that. It really it really rubs me the wrong way.

David Novak 27:01 

Oh, that was fun. I love doing this.

Tell us about your your upbringing.

Madeline Bell 27:11 

So I'm the oldest of three children. My parents were very young when I was born. And when they would introduce me to people, they used to say this is our oldest daughter, Madeline, she's raising us. And I think I probably was a little bit of a of a No at all. And somebody who, you know, started as a young person, as a leader and I my parents talk about that. My mom continues to talk about that today.

David Novak 27:37 

You know, I learned that you actually have a picture of yourself at the age of three under a Christmas tree, wearing a nursing cap. Did you always want to become a nurse? Was this something that you you know, just felt like you're almost born to do

Madeline Bell 27:50 

I really wanted to from a young age not sure if I asked for the nurses cap when I was three years old. But I always wanted to be a nurse and looked up to other people who were nurses. And my mom was also a squeamish person. So whenever anything happened at home, she would call for me and I started to realize like, actually, I'm pretty good in emergency situations, and I can certainly tolerate blood. So it kind of reinforced that feeling that I that I was very interested in being a nurse,

David Novak 28:18 

can you tell us a story about your childhood days that will tell us a lot about the kind of person you are today?

Madeline Bell 28:25 

Well, let me think one of the one of the things as a child that I loved was Girl Scouts. I loved camping, I loved getting badges, I would do everything I could to get, you know, the most amount of badges possible. And I remember even being elected leader of my troop when I had multiple girls who were much older than me, and I came home and I said to my mom, well, they they elected me as the leader of the troop, you know, when there's several girls older than me and, and she and I, you know talked about the fact that I was very interested in being a leader and liked leading people. And I think that sometimes goes along with the territory of being the eldest child and the family. But anyway, I think Girl Scouts was an important contributor to who I am today.

David Novak 29:13 

You don't matter when you went to college. Tell us where you went and why.

Madeline Bell 29:17 

Well, I went to Villanova. I went I was admitted to a multiple other colleges undergraduate but I went to Villanova loved their nursing program had been around for a very long time, but it was also a very, you know, large campus with lots of other areas to learn from. And I got a scholarship there. So that was also a big contributing factor. And then I went to University of Penn for graduate school, which is obviously an amazing school. So two really great places in the Philadelphia area.

David Novak 29:51 

Tell us how you landed your first professional job.

Madeline Bell 29:55 

Well, I became a nurse, you know, after being at Villanova for four years. And in my senior year, I actually applied to work at Children's Hospital of Philadelphia. And it's the only place I really wanted to work, I applied other places, and they put me on a nine month waiting list. And when my name came up, I was two weeks before graduation. And they said, Well, you can start working, but you have to work permanent night shift. And so here I am a 22 year old woman with two roommates who had cool fun daytime jobs. And I was going to go to work when everybody else was going out to have fun, but I agreed to do it because I just wanted to be there. And I wanted to work with children and, and their parents. And so I did and never did, I expect when I walked in the door the first day as a new nurse that someday I would be the CEO of of that same organization

David Novak 30:45 

tell us the story of the most incredible positive experience you had being a pediatric nurse?

Madeline Bell 30:52 

Well, I think the best part about being a pediatric nurse is to teach parents how to care for their children at home that may have an illness. And I also worked as a homecare nurse. And I remember going into homes and seeing families that were very poor. But they had this incredible resilience and ability to take care of children who are very complex on different technology, that sometimes the most educated well to do, families wouldn't be able to do. And so it made me realize that parents are very motivated and can be taught to do some pretty technical things, to care for their children. And for me that that was a very rewarding experience to go into the homes and help families and many times help families who didn't have a lot of means or education, and but did a wonderful job.

David Novak 31:48 

What was your biggest frustration being a nurse?

Madeline Bell 31:52 

I think the biggest frustration I had was what really led me to leave the bedside, which was seeing that there were things in the healthcare system that didn't always work. And being very curious about why you know, who made the decisions and why it is the way it is. So I think what was frustrating to me is that I could care for children, and I could do what was in front of me, but I really wasn't able to impact the bigger picture of healthcare and why we did things the way we did. And so that was a frustration. And that frustration actually led me and the curiosity led me to do what I'm doing today,

David Novak 32:35 

did you have a lightbulb moment where you decided that you wanted to set your sights on hospital administration,

Madeline Bell 32:42 

I think it was one time sitting in the cafeteria talking to a lot of colleagues, and everybody was talking about a frustrating situation. And I thought to myself, well, I could sit here every time, you know, and talk about this frustrating situation, or I could understand the root cause and do something about it. And I remember that day, I remember the people who were around the cafeteria table with me. And it really led me to think about it in a different way and to pursue the career I have today.

David Novak 33:16 

When did it hit you that you said to yourself, you know, I really want to run this place someday?

Madeline Bell 33:20 

Well, it's interesting, I was Chief Operating Officer and I was really happy being the Chief Operating Officer, I had done that for for eight years. And I, I really just enjoyed the challenge of you know, operating a 24/7 operation. But I remember, and this is unfortunate, because this is a lesson I try to teach other people is that it really dawned on me when other people started recruiting me to be CEOs of other hospitals or children's hospitals. And I thought to myself, Wow, if they believe in me, maybe I should really explore this as a career option, because I had not been really thinking in that direction. And so I tried to turn turn that around and say to people don't do what I did, and wait for somebody else to believe in you before you believe in yourself. Believe in yourself before you get that external validation. But frankly, that's what it was. I had lots of inbound calls, saying we really want you board members calling me saying yeah, we want to, you know, to come out and talk with us. And I did a little of that and realize that, yeah, this is actually something I'm interested in, and I can do and other people believe I can do this

David Novak 34:30 

starting out as a nurse, how is that really impacted you being the CEO and the leader you are?

Madeline Bell 34:36 

Well, I think one major trait of nurses is that you have empathy for people. And I think as a leader, it's critically important to have empathy. It's really important to understand and to walk in the shoes of the people that are working for you, particularly people that are many layers below you on the front lines, understanding what's important to them. How They see themselves relating to the big picture. And, frankly, be a baby being able to be where possible, you know, on a first name basis with with folks, you know, even though we have 16,000 employees, I'll never make that goal of being on the first name basis with everybody, but really important to understand what their experiences,

David Novak 35:23 

you know, this is probably a very unfair stereotype. But a lot of times doctors are not really seen as the most empathetic individuals, you know, how do you drive home the importance of empathy to really high high performing doctors that, you know, they have an intense job, The grind is you got to keep moving forward. How do you how do you build that skill?

Madeline Bell 35:47 

Well, it's actually I, I pushed our team to create a leadership development program for physicians. And we spent a lot of time talking about the fact that even though they may not be in a leadership position, that by virtue of the fact that there are physicians, and they're writing orders for other people, that they're the team leaders that everyone is watching them. And that it's really important that they set the right tone, and the things they say sometimes their body language, the things they don't say, really set the tone for the care delivery team. And so letting them first own the fact that people are watching them. And it's important that they do set the tone. Frankly, it's often an aha moment for them, because they sort of saying, you know, I'm out there, I'm doing my thing, I'm taking care of patients, not really realizing that all the people in the care team are taking direction and in watching them so carefully. And I think that giving them that self awareness and reminding them is very important step towards, you know, getting them to a place where they're really not only empathizing with their patients, which I think they do work very well, but for the other members of the care team that are looking up to them for direction.

David Novak 36:58 

Now, when you think about your organization, your world class, you know, Children's Hospital of Philadelphia is renowned, how do you go about raising the bar for such a high performing organization?

Madeline Bell 37:09 

Yeah, I think that's actually difficult because you, you know, you don't want to rest on your laurels. And our goal is to really define care in the future for children. So it's really giving people the expectation that you want them to innovate, that you want them to constantly be defining what is the next generation of pediatric healthcare, we do that many different ways. Some just through the traditional, we have a research institute. Some of it is through an innovation tournaments that we hold on a regular basis. And another is through a program that I developed called the frontier programs that allows people to apply for funding to accelerate their ideas, once they are sort of partially baked, research bench to bedside ideas. And that I think all of those ways, get people thinking and rewarding them to think creatively to define the future in a different way than the past.

David Novak 38:08 

When you looked at your business. How did you go about deciding what cultural behaviors you really wanted to drive and reward so that they would become the culture that you have today?

Madeline Bell 38:18 

Yeah, I think there are a number of things, certainly to the culture of innovation. And when you think about a hospital, in one way, you want to be standard, you know, you want to have standardization, you want to be highly reliable, you want to say every time we do something, we want to do it the exact same way. And so it's complicated for people to say, yes, we want we want you to do everything the same way. Every time you come into the hospital, just like when a plane takes off. You want them to go through that checklist. In the operating room, you want them to go through that checklist, relentless standardization, doing same things at the same time. But how do you drive that standardization? And that, you know, high reliability culture at the same time is telling people to innovate. And you know, you do that, through example, through rewarding behaviors, rewarding people for making mistakes and trying something new. That's very difficult to do in a hospital setting. It takes a lot of nuancing. I think I do I embed messages. Every Monday I do a message to all 16,000 people. So I tried to embed components of the culture I want to drive. Today we're having a leadership briefing for 300 leaders. We do that once a month again, embedding cultural messages. And many times it's just also my actions, not just my words. And so I think there's just many ways to really drive that culture.

David Novak 39:45 

Well. How important is recognition and do you have an initiative that that in particular really makes it a high value to the organization?

Madeline Bell 39:56 

Well, we certainly have something called Bravo where we give people Bravo point It's and I think that's terrific. There's something else that I do. And I did it earlier this week called The Good Catch program. And you know, when people get admitted to hospitals, one in 1000 of them have the opportunity to get harmed. And that's pretty high. If you would get on a plane and no one and 1000 times there'd be an error happening and you'd be harmed, you would never fly. So we really try to create this high reliability culture and reward people for something that we call good catches. And so I meet everybody on a monthly basis who's had a good catch. And as an example, you know, one environmental services worker, was talking to the seven year old boy every day, and she clean was cleaning his floor. And one day she went in, and she noticed that he just wasn't interacting with her in the same way, but she couldn't put her finger on it. She just didn't seem that he was, you know, talking or relating to her. So she went out and got the nurse. And by the time the nurse came to the bedside, he actually had arrested and you know, she saved his life. That was a good catch. And so, you know, everybody, whether you're an environmental services worker, you know, whether you're a nurse at the bedside, you have this opportunity to to do good things. Use your judgment, have that questioning attitude. So I meet everyone on a monthly basis who, who has these types of good catches, and I reinforced the positive behaviors associated with the things that they've done.

David Novak 41:27 

That's fantastic. Madeline, you're really known as being a real innovator in your industry. What are you most proud of?

Madeline Bell 41:36 

Well, I think I'm most proud of really helping our research institute to leverage some of the strengths that we've built already, in some really unique areas of cancer immunotherapy gene therapy. And when I get a letter, which I recently got from a family, whose little girl was born with a genetic disorder, and that would have left her blind by the time she was in her late teens, early 20s. And because of the culture of innovation, the investment in research this summer, she was able to get the injection of two different two genes in each of her eyes that and replace the bad gene, and is now able to see and do things that she wasn't able to do for and when I get letters like that, it's such a reinforcer to me that, you know, doubling down on investing in research, which is, frankly, doesn't show an immediate return. But it's a return on mission, not a return necessarily on monetary investment, is is really very motivating to me to continue to do that.

David Novak 42:41 

Well, you have such a noble cause for your work, which is fantastic. And you mentioned earlier that one of the things you do to drive innovation is the Frontier program, what was the genesis for that?

Madeline Bell 42:53 

Well, it was really just the recognition that there were a lot of good ideas among these 16,000 people. And some of them that were not brand new ideas that were looking to to be hatched, but ideas that had been hatched an incubating, but just needed some acceleration to scale them. And, you know, in the past, it would take many, many years to get your research or your ideas to the point where you could get external federal funding. By that time. You know, it wasn't such a new idea anymore. So this was just a way to say I'm going to, I'm going to bet on you and believe in you and believe in your science, your ideas, and I'm going to help you realize your goals of scaling this to more patients. And it's been so wildly successful, and it's, you know, gives people excitement and hope that, you know, sometimes these cures could take decades to occur. And to help accelerate and scale them allows the researcher to realize their dreams and, you know, often less time than it than it typically would.

David Novak 43:59 

Fantastic. You know, I know you've collaborated with Penn and Novartis to develop a drug for leukemia. Tell us how you brought that about. It's difficult to bring different parties together. And yeah, everybody on the same page,

Madeline Bell 44:14 

you know, it's interesting at the leadership level, I would say that, but luckily, on the ground at the physician scientists level people collaborate really well. And sometimes it's about getting out of their way and letting them collaborate and doing well. So, you know, a lot of the science behind the innovation was at Penn, but the application of that innovation was about taking a chance. And Emily Whitehead, who has been widely reported in the news was the first patient and she really had no help. And our physician said to her families, she'll probably have about 12 hours to live. So the Hail Mary is trying something that's never been tried before. But we're going to we're going to do it. And, you know, call the researcher at Penn and said, Okay, we're going to do This on a patient provided her with, with the with the with the cells, the RE engineered cells to, to to eat her cancer, to sit to say it very bluntly. And she ended up having a really bad reaction. And our doctors got to put their heads together and said, What can we do to counterbalance this reaction and they they really thought outside the box applied something. And it worked in 12 hours later, she was off life support. And you know, you know, it seemed like a miracle story. And now there's been several 100 children who have had this therapy with, you know, a 90% success rate. And children with relapsed leukemia previously had a 10% chance of living, so to go from 10% to 90%. But it was just that teamwork, that collaboration that putting their heads together to say, you know, we're going to think outside the box, she's having something called a cytokine storm. We don't know what to do with this. But there's this drug that works on, you know, might work but has never been tried before. And I think it's just that, you know, creativity and innovation and teamwork that allowed that to happen. Can you tell us

David Novak 46:15 

a story about the two year old that comes in your hospital, without TV in two hands and no money to pay for a procedure. And then the decision you made on the spot and what the ultimate outcome was?

Madeline Bell 46:32 

Well, this little boy was in another hospital. And because he had a bad infection, he lost his his extremities, his hands and his feet. And he had come to our hospital and our Surgeon and chief came to me and said, Look, we have this really unique opportunity to perform a double hand transplant. That's never been done before. This is the perfect patient where we think we have the highest likelihood of success, but we won't get paid for it. And we don't know how long it will take. Because, frankly, what has to happen is another child of the same size, and skin color and tissue type has to pass away. And those family members have to agree on the spot, donate their hands. So what are the chances that that would happen? But we, you know, he said, Will you give me permission to start this process? And I said, Yes, and then are good, because I thought that's what we're about. We're about innovation, taking chances, calculated risks by taking taking risks. And at the same time, our chief marketing officer came to me and said, Well, this is going to cost us 10s of 1000s of dollars. But we would like to to videotape, every one of his sessions, including his surgery, if it ever happens, because the chance of it happened was actually very small. And I said, Okay, so we're gonna do all this for free. And we're gonna spend 10s of 1000s of dollars on this, you know, high level video audio crew that's going to follow him around, and all his doctor visits and at school and at home and and wait for this, this this thing to happen. So I said yes, because again, if this happened, and it was successful, what an amazing story, it would be. And four months later, donor hands became available that were the perfect match in every way. While that was happening in the four months, our team was simulating this whole exercise, they printed out on a on a on a printer. They printed out you know, simulated hands that and they they just practice and practice and practice over and over again, team of 40 people hoping that it would happen but not knowing for sure. Donor hands key became available. And they took all that work that they learned with the 3d printer, you know, hands, and it was completely successful. And I get to see him periodically. In fact, I'm going to be interviewing him for my podcast at South by Southwest coming up this year, and his surgery surgical team. And, you know, the rest is history. And and luckily we've been able to tell the story because we documented all along the way.

David Novak 49:15 

Wow. That's that's just an amazing story. Shifting gears a bit here. What's the best advice you you give women on how to elevate themselves in the workplace?

Madeline Bell 49:27 

Well, I it's it's all about in their head, you know, reminding them that they need to convince themselves first before they can convince other people that they belong that they own it, helping them to get the impostor syndrome out of their head. I mean by impostor, yeah, you know, so many times I remember, I was talking to a physician, a woman who had you know, the best medical school pedigrees you can imagine. Was is the VIP you know, when I have a VIP You family, she's like the go to person. She had gotten promoted to be a head of a center, and I sat down with her at for coffee, she said, I'd love some advice. And the first thing she did was tell me that she didn't think she deserved this, this, this promotion, and that she thought other people and thought maybe other people thought the same thing. And I said, what you need to do right now is stop that narrative right away, get that out of your head, own it, feel good about it, and then start thinking about what do I want to do in one year? What do I want to do in five years? How do I told my boss, that's what I'm going to do. And so we spent a lot of time and I this is, I'm telling you about a conversation that I've had dozens and dozens of times with women. So so many, so many times, I think it's about self confidence and owning this yourself, before you can convince other people.

David Novak 50:57 

What is it? That is innate? You think, with women where that is a challenge? Is there anything, you know, that drives that in your opinion?

Madeline Bell 51:07 

Yeah, I think that, you know, sometimes women are taught or maybe raised, certainly in my generation, that women need to be polite, they, they need to be good. That maybe asserting themselves is not feminine. And you know, that's the only thing I can think of, because it's so pervasive in my experience. And, you know, I'm hoping next generations, and each subsequent generation, some of those things that I see will will change. But it's it's probably the most frequent conversation I have with with women about advancing their careers.

David Novak 51:45 

Well, and what would be the three bits of advice you'd give to aspiring leaders, the three most important things you'd think you could tell somebody?

Madeline Bell 51:54 

Well, I think one thing is to recognize that people watch you. And I mentioned this earlier when I talk about physicians, but I think leaders always forget that somebody watches, what they listen carefully to what they say they watch their body language, they watch who they promote, how they spend their time. And to be strategic about that, you know, and I think a lot of times leaders forget that. So that I think is really, really important. The other thing I'd like to emphasize is the importance of of having empathy for the people that work with you. And to really have strategies to work on. Getting that information, listening tours, whatever you want to call it, situational awareness of what's happening in your organization, Undercover Boss, what you know, whatever way you want to do it, I think is really, really important. And I would say last is is is to really to be an effective leader is to empower the people that work for you. drive decision making down, make them feel that they're able to, to run their business unit to make decisions to make mistakes, learn from their mistakes, and not everything needs to come up to you as as the leader and to feel really comfortable that you shine when they shine, and that you take credit for their work it and help them promote themselves. And that's your greatest reward.

David Novak 53:25 

Well, Madeline, there's no doubt you're certainly a great leader yourself and making the world a better place. And I want to thank you so much for taking the time to share your insights.

Madeline Bell 53:36 

I'm thrilled to have had the opportunity to be here with you today. Why

David Novak 53:47 

don't you just love how Madeline handles herself as a leader. She is truly the real deal and exhibits the behaviors that she wants to see throughout her hospital. During the COVID 19 crisis, she needed her team to stay calm. So she intentionally set a tone of calm and reassurance. She also felt that she needed her team to feel like they could take time off work for self care. Given the incredible hours everyone was working. So she made it a point to take a day to recharge to. She wanted her staff to listen to patients. So she intentionally schedules listening tours herself. She understands the leadership power of her own actions. And now it's time where I get to give you a little coaching so that you can develop into a better leader this week. As a part of your weekly personal development plan. I want you to ask yourself two big questions. First, what qualities do you want to develop in your team? Second, what specific behaviors can you model that will demonstrate those qualities? For example, say you need more innovation and creativity from your team? Well model a behavior that encourages it, like making it a point to get out out of the office for a day to do some big picture dreaming and then make sure that your team knows about it. And if you need more positivity on your team, think about your own body language and tone during the day. Do you give off the same kind of positive energy that you feel like you need from your team? Remember that your team may not be listening, but they are always watching. So be strategic with your words and actions as a leader and model what you want to see more of. So do you want to know how leaders lead while we learned today is that great leaders model the right behaviors. Thanks again for tuning in to another episode of how leaders lead where every Thursday you get to listen in while I interview some of the very best leaders in the world. I make it a point to give you something simple on each episode that you can apply to your business so that you will become the best leader you can be