Insights Series Issue 18: "Firefighters don't run from fires"

A thought leadership paper on how one New York healthcare organization stepped up during the COVID-19 crisis.

Insights Series Issue 18 transforming-care-delivery The New Normal Feb Mar Apr M Oct Nov Dec Firefighters don’t run from fires How one New York healthcare organization stepped up during the COVID-19 crisis A thought leadership paper on how to “Transform care delivery” SIEMENS Healthineers Preface The Insights Series The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. The Series explores emerging issues and provides you with practical solutions to today’s most pressing healthcare challenges. We believe that increasing value in healthcare – delivering better outcomes at lower cost – rests on four strategies. These four principles serve as the cornerstones of the Insights Series. Expanding Transforming Improving Digitalizing precision care patient healthcare medicine delivery experience The New Normal The New Normal is a special edition of our Insights Series focusing on the COVID-19 pandemic. This series provides recommendations on how to confront the current SARS-CoV-2 outbreak and its implications, as well as strategies and ideas on how to emerge from the current crisis stronger, more resilient, and better prepared to address the healthcare challenges that lie ahead. Please visit Foreword The COVID-19 pandemic has disrupted virtually This paper is more of a story than a set of insights or every aspect of our lives and fundamentally recommendations – a story told largely through the changed the way we think about healthcare words and emails of Zwanger-Pesiri COO Bob Day. and those who deliver that much-needed care. He noted early on that “firefighters don’t run from fires,” deciding that he and his team would demonstrate that In the United States, we’ve been hit particularly hard; same professionalism and commitment. COVID-19 has claimed the lives of more than 500,000 Americans. Still, within these hardships are remarkable Day understood that in times of uncertainty, steady examples of determination, persistence, and compas- yet inspiring leadership is a necessity. This paper offers sion, as thousands of healthcare providers continue to an in-depth look at his leadership, the challenges his care for patients despite tremendous challenges and practice faced, and the successes they shared. limited resources. On behalf of Siemens Healthineers, I wish to express At Siemens Healthineers, we’ve also done our part our gratitude to the Zwanger-Pesiri team and to all to help, providing healthcare workers with medtech healthcare providers for their fearless work throughout products and services to combat the virus, as well the pandemic. You are our heroes, and we are proud to as sharing information about the pandemic and its work with you. impact. This includes special editions of our Insights Series papers called “The New Normal.” This paper David Pacitti is part of that series, detailing how one New York President and Head of the imaging provider, Zwanger-Pesiri, responded to the Americas, Siemens Healthineers crisis by adapting procedures, redefining staff roles, and re-thinking every aspect of their operations. Zwanger-Pesiri remained open throughout the pandemic and managed to retain a base of loyal, grateful patients and a staff of confident, committed workers. Siemens Healthineers Insights Series · Issue 18 3 Background + + Zwanger-Pesiri Radiology “The ‘how’ is always the part founded 1958 that requires a certain fortitude, an ability to make a decision and then Key figures (as of 2020) quickly change course, stay 32 sites throughout the New York area confident but be humble. 1,250 employees 1,200,000 exams p.a. You may not always have More than 50% of all MRI exams within all the answers yourself their geographic catchment area and not every decision is correct right out of the box, you correct them and make adjustments on the fly.” Bob Day, April 19th, 2020 4 Issue 18 · Siemens Healthineers Insights Series COVID-19 was officially declared to be a worldwide There were also many cases of physicians shifting, or pandemic in March 2020. In those early days, New being shifted, to work exclusively with COVID-19 York City (NYC) was the North American epicenter patients. As Dr. Hadi Halazun wrote in an opinion piece of the crisis. The week of March 8th, there was an for the New York Times in April 2020, “Yesterday we average of 274 COVID-19 diagnoses per day.¹ were your pediatricians. Your cardiologists. Your By the week of March 29th, that average had reached surgeons. Today, we are all COVID-19 doctors. Your a peak of 5,132 cases per day.¹ Between March 15th appointments are canceled, and our offices are closed. and May 2nd, 2020, approximately 30,500 Americans We’ve been called to the front lines.”⁴ died from COVID-19.² About half of those deaths were in New York City.² During this time, New Yorkers must All in all, it was a situation that left many NYC healthcare surely have felt that they were living in a city under organizations pondering the advisability, and viability, of siege. And as challenging, inconvenient and remaining open during the pandemic. One such organi- dangerous as it was for ordinary citizens, it was zation was Zwanger-Pesiri (ZP) Radiology, an indepen- dramatically more challenging, inconvenient, and dent radiology service provider operating in the Greater dangerous for healthcare workers. New York area. Founded in 1958, the family-owned busi- ness employs more than 1,250 people at 32 locations In the early days and weeks of COVID-19, healthcare throughout the New York area. They perform more than workers faced enormous challenges. They dealt with a 1,200,000 exams annually, including more than half of seemingly unending flood of sick and dying patients, all MRI exams within their geographic catchment area. knowing that even as they cared for these people, they might be endangering themselves. Like everyone else, they had to take care of their children at home, because schools were closed. Moreover, their increased likelihood of being exposed to the virus at work also increased the Survey among NYC healthcare workers likelihood of them spreading the virus to family conducted in April 2020³ members. This only added to the stress and uncertainty that NYC healthcare workers had to bear. According to one study, 57% of the city’s healthcare staff had acute Acute stress 57% stress, nearly half screened positive for depressive symp- toms, and one third had anxiety symptoms.³ As a result, many healthcare workers stayed away from work. Many Depression 45% others, of course, were unable to work because they had to self-isolate, or in some cases because they had to be Anxiety 33% hospitalized themselves. Siemens Healthineers Insights Series · Issue 18 5 ZP CEO Dr. Steven Mendelsohn and COO Bob Day looked This paper looks at the journey that Zwanger-Pesiri at the havoc being wreaked by COVID-19 and realized undertook at the start of the COVID-19 pandemic, they had a decision to make. Could a company that had keeping their doors open at a time when many organiza- built its reputation on providing first-class, dependable tions could not. We are fortunate to have had the benefit service to its community now close its doors, precisely at of access to the many emails and other forms of internal a time when medical care was needed more than ever? communications sent by Bob Day to his team during The answer, in their case, was no, though it was a deci- these dark days and weeks. We were afforded an oppor- sion taken with some trepidation. As Bob Day remem- tunity to follow, in real time, the thinking and decision- bers, everyone at ZP was aware of the risks associated making of a leader working against significant odds to with the decision to remain open. Many were convinced get his team through a serious crisis. The many quotes it wasn’t a good business decision – at least in the short- used in this paper primarily came from Bob Day’s emails, term – but Day was confident it was the right decision in and they reflect the information he had, or lacked, the long-term. As he said at the time: depending on when during the unfolding pandemic they were sent. “Firefighters don’t run from fires ... ”⁵ “Our patients need us in their time of need and the hospitals are over- whelmed. The staff need jobs and a source of income. When this is over, we want to be here knowing we stayed in the fight and we never changed who we are. Not even this overwhelming crisis would knock us off our game.” Bob Day, April 19th, 2020. 6 Issue 18 · Siemens Healthineers Insights Series “We’ve redefined what it means to be busy.” Bob Day⁵ The challenge The COVID-19 pandemic completely changed the The second fundamental challenge was keeping the landscape for Zwanger-Pesiri and for other similar practice open. This required more than just keeping the healthcare providers. The bold decision to stay doors open; patients also had to know that ZP was there, open having been made, Mendelsohn and Day were ready and willing to help them. Traditionally, ZP received suddenly struck by the challenges they had set for their patients through referring physicians. However, as themselves. COVID-19 took hold, most of these physicians had either closed their doors or shifted to pandemic-related work. As Bob Day said in an email to employees in mid-March, By Bob Day’s estimate, 80% of ZP’s referring physicians “I promise you all, I will keep trying to find any way I can were no longer working by April of 2020. The organiza- to serve our patients, keep the practice open, and keep tion suddenly had to reach out to patients and to the you safe.” It is these three challenges that defined his public directly. This demanded a re-think of how they work over the months ahead. positioned themselves, updated marketing messages, new visibility and advertising, and heightened customer- The most essential of the three was ensuring employee awareness. Treating the “sickest of the sick” during a and patient safety. During the early months of the pandemic is a noble mission, but it is only possible if pandemic, the level of anxiety among both patients and these patients know that your doors are open. employees was high. This virus was new and there was no reliable information on how it spread, on immunity, The third challenge was internal: serving patients in or on treatment protocols. Meanwhile, news from other new ways. In addition to providing imaging services, parts of the world offered stark images of death and other operational changes to ZP’s daily work became devastation. In such circumstances, healthcare workers necessary. One example was communicating results were understandably concerned about coming to work. of imaging procedures. Previously, once radiology tests Others had no choice; they were forced to remain in had been completed, this data was sent to the referring quarantine because of possible exposure to the virus physician who in turn communicated these results to or in some cases because of actual illness. Patients the patient. With these referring physicians no longer had similar worries, particularly as civic leaders called available, ZP had to share these results with patients for people to ‘shelter at home’. Safety had to be job directly. This called for staff to develop new number one. communication skills – a “bedside manner” of sorts. This not only added a new step to their work, it was also, in the words of Bob Day, a “philosophical change” for many radiologists. Siemens Healthineers Insights Series · Issue 18 7 The solution Leadership principles “I am sure someday down the road I may be asked how ZP was able to hold it 1. Communicate together, keep going and never miss a beat. There is a simple answer to that question. It’s what allows 2. Be transparent us to be different and special. It’s a two-word answer: OUR PEOPLE!!!!!” Bob Day, May 7th, 2020 3. Protect 4. Learn as you go 5. Celebrate results and achievements * 8 Issue 18 · Siemens Healthineers Insights Series Bob Day joined Zwanger-Pesiri 20 years ago as an MRI Looking back on those early days of the pandemic, Bob technologist. He is now Chief Operating Officer of the Day admits that the best way for him to make decisions organization, having long since traded in his medical about how to keep ZP’s offices functioning was to “turn gown for a suit and tie. There were times, in the early off the TV news and trust my gut. We needed to make days of the pandemic, when 75% of his workforce was decisions on the fly, and we had little or no clear guid- suddenly not available, either because of quarantine ance from medical or public health authorities.”⁵ restrictions or concerns about their safety. On those days, he realized he would have to return to frontline What Day realized is that in such uncertain times he duty. He quickly rediscovered his skills as a techni- could only depend on himself and his staff. So he kept cian, but as it turned out, he also had to perform things as simple as possible. Deal first with the problems other tasks as well. Cleaning staff were in short in front of you. Never lose sight of the fact that you are supply during the pandemic, so Bob Day did his in the business of looking after sick people. And never part, sweeping, cleaning and disinfecting surfaces forget that people – patients as well as staff – need to at the end of the day. feel safe. Understanding that story, and imagining the effect it With that in mind, and the challenges ZP faced, Bob Day had on staff to see a member of senior management followed five leadership principles. pushing a broom and operating medical equipment, is key to understanding ZP’s success during the pandemic. The people who worked there understood that it was not going to be business as usual, and the folks in charge would do whatever needed doing to get the job done and not run from this challenge. Siemens Healthineers Insights Series · Issue 18 9 “I think I’ve written more emails in the last week than I have in the last 5 years combined.” Bob Day, March 18th, 2020 1 Communicate Day wrote literally hundreds of emails during this period. In 2003, Dr. Robert Ulmer, Matthew Seeger and Timothy This one captures his attitude and approach: Sellnow wrote a book about how organizations should respond to crisis. Their central point was this: “Communi- cation is the primary means for organizations to reduce uncertainty and coordinate actions.”⁶ “As we begin to piece our practice back together, From the management of the crisis to recovery, and I have some thoughts, general concepts often even to post-crisis growth, the key historically has or themes that are in my head: been good communication. The way Bob Day saw it, he • We will be better and stronger and Steven Mendelsohn were asking a great deal of ZP’s • It will be different staff at an extremely challenging and uncertain time. • Efficiencies- do more with less And the least he could do was to make sure they knew • Multi-tasking, cross training exactly what was going on. • We will reinvent every workflow/process and streamline them all So the principle rule embraced by Bob Day as he • We need buy in from everyone with prepared for the epic challenge ahead was to communi- all our upcoming changes cate with his team. Regular, honest, open communica- • No rank no privilege, all hands on deck tion via phone, face-to-face and most often email, every • Only positive attitudes, negativity has single day. The idea was to establish common cause, to no place convey the sense that regardless of what was going on • We will continue to support and grow outside in the city, within the doors of Zwanger-Pesiri our amazing leadership healthcare was being practiced by a team of dedicated • We have discovered and will continue professionals. to mentor our new rising leaders • Hope and hard work won out. It got us this far so we will never change and stay true to who we are Happy Mother’s Day to all the Moms out there. You make the world a better place for all of us. Have a great weekend” – Bob Day, May 9th, 2020 10 Issue 18 · Siemens Healthineers Insights Series “I am going into survival mode and promise I will do whatever I can to keep this going.“ Bob Day, March 27th, 2020 2 Be transparent Every day, ZP staff knew they could count on receiving There is occasionally an instinct at the executive level an email from the boss, detailing how the day had gone, to hide bad news from employees. As Amy Edmondson, laying out how many examinations had been done, reas- Professor of Leadership and Management at Harvard suring people that they would be paid and, on bad days, Business School, noted in the Harvard Business Review, giving them reason to believe that things would soon “Transparency is ‘job one’ for leaders in a crisis. Be clear turn around. what you know, what you don’t know, and what you’re doing to learn more ... Hiding bad news is virtually a reflex in most organizations, but thoughtful leaders recognize that speaking up early and truthfully is a vital strategy in a fast-moving crisis.”⁷ For Bob Day, a big part of communicating with his staff was communicating everything, bad news as well as good. Day knew that when a company faces financial challenges, the employees face them as well. As his emails from that time show, he made no effort to hide from his staff the perils the organization faced, as patient volumes dropped and revenues shrank. “This is the email I had hoped to avoid. We continue to be in free fall with declining patient volumes.“ – Bob Day, March 23rd, 2020 Siemens Healthineers Insights Series · Issue 18 11 “At any time if you feel we are not protecting you adequately or the risk outweighs the reward you have every right to step away. Again, no judgment and we will see you when this is all behind us and you feel comfortable returning to work.” Bob Day, April 21st, 2020 3 Protect As financial pressures mounted in the spring of 2020, In addition to limiting interaction between staff and Bob Day recognized the crucial importance of keeping patients, ZP asked patients to answer a number of the entire ZP organization financially viable. Only then screening questions, focusing on their possible could they provide care to their patients and a livelihood exposure to COVID-19, and staff were provided with for their employees. But an even more fundamental chal- clear guidance about how to respond if patients’ lenge was ensuring everyone’s safety. If people were not answers triggered concerns. Day also made it a priority protected from the virus, the entire enterprise would to ensure that his people had the best personal falter – and people’s lives would be at risk. protective equipment. He saw it as the absolute minimum that ZP could do, given its commitment ZP brought in a number of innovative measures to to helping everyone who needed it. protect staff and patients. Workflows were adjusted. Patient protocols were tightened, for example by ex- “We are protected. We must follow protocol,” said Day at cluding family members. Even the registration process the time. “We will see high risk patients. All the question- was streamlined, with much of this work being trans- able patients. We are helping those patients who have ferred from the reception desk to the parking lot. nowhere else to go.” (April 10th, 2020). Patients were able to register digitally, directly from their cars, where they then waited for their exams. When it was time for their exam, they received a notification or text message and proceeded directly to the scan, thus limiting contact with employees and with other patients. 10,000 cases 110% 100% 99% 101% 104% 99% 98% 86% 5,000 cases 72% 57% 35% Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2020 Patient exams at ZP (Feb 2020 = 100%) New COVID-19 cases in New York (7-day average)¹⁰ 12 Issue 18 · Siemens Healthineers Insights Series “I went to the library to look for a book on how to deal with a ‘Coronavirus Crisis for Outpatient Radiology’. They were either all checked out or no one has written on this subject.” Bob Day, March 18th, 2020 4 Learn as you go The staff at ZP were part of this process, fully engaged One of the most unsettling aspects of COVID-19, in acquiring data from their first-hand experiences and especially early on, was how new and different it was. observations, and applying this new information. Every There was little reliable information about how to deal day at ZP, the team gained fresh knowledge about the with it – something to which the healthcare industry virus – everything from new disinfection measures, more is unaccustomed. Today, everyone from senior surgeons efficient workflows or better ways of diagnosing COVID- to patients relies on having established, verified 19. Bob Day made it clear early and often that as soon knowledge. They are used to consulting reliable sources as useful facts were verified, they should be shared and having recognized experts to refer to. Suddenly this across all sites and among all staff immediately. Staff foundation of established expertise was non-existent. became accustomed to receiving emails like this one from their boss: With the scientific certainty that the medical community normally takes for granted suddenly unavailable, caregivers had to embrace an entirely new approach to learning and decision-making. Lorraine Daston of “This is information on how it works in the Max Planck Institute has referred to this type of the HIGH-RISK OFFICE. We will be information-gathering and decision-making as “ground wearing N95 masks. A gown, dispos- zero empiricism”, a method of acquiring information able pants, gloves -2 sets, eye and knowledge in real time, one fact and one experience goggles, booties and hairnet with at a time, not unlike what was common in the seven- long hair in a bun or ponytail. NO teenth century.⁸ jewelry. We will remain in all the protective gear, EXCEPT for lunch. According to Daston, “Chance observations, apparent All of this was done by CDC guide- correlations, and anecdotes that would ordinarily barely lines. The Assistant Directors and merit mention, much less publication in peer-reviewed myself went through training to put journals, had the internet buzzing with speculations all of this on and off. We will show all among physicians, virologists, epidemiologists, of you. As well as the Nurses made a microbiologists, and the interested lay public.”⁸ video and they will be making rounds to those offices.” – Email from an employee shared by Bob Day, April 10th, 2020 Siemens Healthineers Insights Series · Issue 18 13 “I continue to be amazed and could not be prouder to be a part of this team. You all give me strength and keep me going.” Bob Day, May 17th, 2020 5 Celebrate results and achievements This was one of many stories that Day shared with There is growing understanding in the business employees, helping them to appreciate the value of their community that acknowledging and celebrating the efforts. He also made it a daily priority to share with accomplishments of employees is not just a nice thing them his personal appreciation for their efforts, their to do, it is the right thing to do for the business. Studies commitment and their willingness to put themselves at have shown that a working environment in which risk for patients and for the organization. On the 16th of employees are praised and appreciated leads to lower May, he wrote this: turnover and increased productivity.⁹ During a time of crisis and uncertainty, such praise and recognition are particularly important.⁹ “I want to thank all of you for these past In the case of ZP, the contribution of employees – the two months of hard work and dedication. determination and courage they showed day in and day The sacrifices you have made are truly out – never went unnoticed, or un-celebrated. Bob Day inspiring and remarkable. The stress and and the ZP management team made it a priority to let fear you have endured goes above and their employees know the difference their service was beyond my wildest expectations. Many of making in people’s lives. One story he made sure to you have worked without a day off and circulate was about a nine-year old boy who, for the some of you have been separated from purposes of this paper, we will call John. your loved ones due to your exposure to the virus. I feel your pain and know the Many radiology services are elective. They can be cost you have paid to keep the practice re-scheduled or postponed to suit a patient’s schedule. alive and to be there for our patients. In other cases, however, a timely scan is absolutely I am also aware of many of you working essential. During the pandemic, the patients who came beyond 40 hours and clocking out and not through ZP’s door were, in the words of Bob Day, the being paid for the additional hours “sickest of the sick,” often with serious medical condi- worked. You are an incredible group and tions and with nowhere else to turn. One such patient unique team of individuals. The practice, was John, who arrived at the clinic after suffering a bad Dr. Mendelsohn and I, will never forget headache for several days. Under normal circumstances your heroic efforts. From the bottom of John would have gone to his local hospital, but when our hearts THANK YOU!!!” – his grandmother contacted that hospital, she was told that because of COVID-19, there was simply no capacity. Bob Day, May 16th, 2020 John and his grandmother tried ZP, and they were told that capacity would be found. John’s same-day scan revealed a brain tumor that required immediate treat- ment, which might otherwise have gone un-diagnosed for weeks. 14 Issue 18 · Siemens Healthineers Insights Series “You don’t know how fast you can run until you have a dog chasing you.” Conclusion Bob Day⁵ The approach taken by Bob Day at Zwanger-Pesiri is not a blueprint for crisis management, nor is it a checklist of pandemic do’s and don’ts. What Bob Day’s “I just want to tell you how much energy, passion, and determination offer us is a snap- I appreciate your company … shot of how a real leader can improvise and adapt in the technician and radiologist could the face of a tornado of startling new developments, not have been better … I spoke to while maintaining an unshakable commitment to a the woman at the phone, she could set of clear principles, to his staff and to his patients. not have been nicer.” – Patient, March 31st, 2020 ZP emerged from the early days of the COVID-19 pandemic having accomplished something quite extraor- dinary. They pulled together in the face of widespread confusion and fear, at a time when nobody knew what was happening or how to cope, and they offered patients who were in need an open door and professional help. Every day, the team diagnosed more than 200 at-risk patients who literally had nowhere else to turn because “I was really nervous and almost hospitals could no longer take them in. In many cases, cancelled my appointment. I pulled the team at ZP found evidence of serious illnesses that up and before I even got in the door, would have gone undiagnosed for too long. And what I was greeted by an employee with a they heard from their patients is that it was greatly gown and mask on. She asked me appreciated. questions and took my temperature. I was so happy they were taking such precautions. Then after my Doppler was done and I was getting dressed and putting my shoes on, the techni- cian was already disinfecting every- thing. That made me smile a little wider. ... Thank you for making my testing a little easier.” – Patient, April 4th, 2020 Siemens Healthineers Insights Series · Issue 18 15 The team at ZP had no time to rest on their laurels. In addition to keeping the business operating, Bob Day A second wave hit New York in the fall of 2020, and and the entire ZP team also worked hard learn from what as 2021 begins an end to the pandemic is not yet in they saw and experienced throughout the pandemic and sight. Yet for Bob Day and the team at ZP, it continues to respond appropriately. They introduced measures such to be business as usual. as employee temperature stations at every time clock, questionnaires that need to be filled out regularly, and As Bob Day put it in December of 2020, a full nine disinfecting offices and workspaces every evening. These months after the pandemic first hit: changes were in response to the pandemic, but many are likely to endure even after the COVID-19 crisis subsides. What has not changed at ZP, of course, is Bob Day. He is “The game plan hasn’t changed, I always still running towards that fire. He remains committed to make our first priority staff and patient his staff and his patients, to his company and to the safety with the understanding we are New York area. He continues to believe that leading by health care providers and we also have a example is the only way to lead, and he still writes a lot business that we want to remain viable ... of emails like this one: We have done this before, we are battle tested and willing and able to do it again.” – Bob Day, December 7th, 2020 “I give up trying to predict when it may happen but some day life will be back to finding something other than COVID to obsess and worry about and then we will Perhaps the most extraordinary thing about the be back to normal. Until that day when Zwanger-Pesiri story is that they not only made it ‘normal’ returns we stick together and through the pandemic’s first wave in early 2020, they stay locked in to the script and do what actually saw their patient volumes remain steady we do ... Wear your masks, wash your throughout this unsettled time. The main reason for hands, social distance when possible, this is the large number of new patients whom they don’t let your guard down, treat the virus served. During the pandemic’s first wave, more than with respect and most importantly you 70% of the patients they saw were new patients. and your loved ones stay safe.” – Bob Day, December 7th, 2020 16 Issue 18 · Siemens Healthineers Insights Series Suggested follow-up on • Insights Series, Issue 17: Protecting those who protect others: Steps to ensure caregivers’ physical and mental health workers-covid-19 • Insights Series, Issue 10: Remote work for healthcare professionals healthcare • Insights Series, Issue 9: Managing the impact of caregiver stress and trauma in the COVID-19 era: a strategy toward resilience-building Information H. The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. It explores emerging issues and provides practical solutions to today’s most pressing healthcare challenges. All issues of the Insights Series can be found here: Contact If you have further questions or would like to reach out to us, please do not hesitate to contact our expert directly: Dr. Herbert Staehr Vice President Global Head of Transforming Care Delivery at Siemens Healthineers [email protected] Siemens Healthineers Insights Series · Issue 18 17 About the authors Dr. Herbert Staehr Dr. Ralf Meinhardt Vice President Senior Global Marketing Manager Global Head of Transforming Care at Siemens Healthineers Delivery at Siemens Healthineers Ralf Meinhardt leads Siemens Healthineers’ thought Herbert Staehr serves as Global Head of Transforming leadership activities related to Transforming Care Care Delivery for Siemens Healthineers, driving the Delivery. Previously, Ralf worked in the pharmaceutical company’s activities and messaging around delivering industry, as well consulting and scientific research. high-value care. In this capacity, he develops and Ralf holds a Doctor of Economics and Social Sciences executes programs and outreach strategies aimed at degree from the University of Erlangen-Nuremberg. healthcare providers around the world, as well as He also holds a Master of Science degree in Management stakeholders in every branch of the healthcare industry. as well as a Bachelor of Arts degree in Business Before joining Siemens Healthineers, Herbert spent Administration. In addition to his academic work at the several years with one of Germany’s leading private University of Erlangen-Nuremberg, he also studied at hospital groups, as head of the Corporate Development the Indian Institute of Management, Bangalore (IIMB). department and serving as Managing Director of an His scientific background is in the field of corporate acute care and a post- acute care hospital in Germany. strategy, a subject on which he has authored several He also spent several years with McKinsey & Company publications. with their healthcare practice, providing strategic advice to a wide range of international clients. Herbert holds a doctorate in Healthcare Economics from the University of Hohenheim. 18 Issue 18 · Siemens Healthineers Insights Series References 1. Thompson CN, Baumgartner J, Pichardo 8. Daston L. Ground-Zero Empiricism C, Toro B, Li L, Arciuolo R, et al. [Internet]. Critical Inquiry. 2020 [cited COVID-19 Outbreak – New York City , 2020 Jul 30]. Available from: critinq. February 29 – June 1 , 2020. Morbidity and Mortality Weekly Report - US ground-zero-empiricism/ Department of Health and Human Services/Centers for Disease Control 9. Gostick A. Carrot Principle: How the Best and Prevention. 2020;69(46):1725–9. Managers Use Recognition to Engage Their People, Retain Talent, and Accel- 2. Lu D. There Has Been an Increase in erate Performance. Free Press; 2009. Other Causes of Deaths, Not Just Coro- 256 p. navirus [Internet]. The New York Times. 2020 [cited 2020 Jul 30]. Available 10. The New York Times. New York Corona- from: virus Map and Case Count [Internet]. 2020/06/01/us/coronavirus-deaths- 2020 [cited 2020 Dec 21]. Available new-york-new-jersey.html from: us/new-york-coronavirus-cases.html 3. Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, et al. Psychological distress, coping behaviors, and prefer- ences for support among New York healthcare workers during the COVID-19 pandemic. General Hospital Psychiatry [Internet]. 2020;66(September-October 2020):1–8. Available from: sciencedi- S0163834320300839 4. Halazun H. ‘Today, We Are All Covid-19 Doctors’ [Internet]. The New York Times. 2020 [cited 2020 Jul 30]. Available from: opinion/coronavirus-doctor-covid. html 5. Day, Robert. 2020. Interview. Conducted by Franziska Herberger, Thomas Jakobsh, Dr. Ralf Meinhardt, Dr. Herbert Stähr, 12 June 2020 6. Seeger MW, Sellnow TL, Ulmer RR. Communication and Organizational Crisis. page 67. Westport, CT: Praeger; 2003. 309 p. 7. Edmondson AC. Don’t Hide Bad News in Times of Crisis [Internet]. Harvard Busi- ness Review. 2020 [cited 2020 Jul 30]. Available from: hide-bad-news-in-times-of-crisis Siemens Healthineers Insights Series · Issue 18 19 At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide benefit every day from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We are a leading medical technology company with over 120 years of experience and 18,500 patents globally. With about 50,000 dedicated colleagues in over 70 countries, we will continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 Published by Siemens Healthcare GmbH · 0221 · ©Siemens Healthcare GmbH, 2021

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