Marc Harrison: Good afternoon, I'm Dr. Marc Harrison, CEO of Intermountain Healthcare. Today I'm with Kristen Bowles, a learning business partner from our education team. Kristen, would you mind telling us a little bit about yourself and your role, and then I'd love to hear your question and have a conversation with you.

Kristen Bowles: Yeah, sure. So my favorite way to describe my tenure with Intermountain is that I've now worked here about half my life. I started as a student, actually, and never intended to stay more than 12 weeks. One good thing after another kept happening. So I started in cardiac rehab, moved on to health promotion with SelectHealth, moved into Homecare as an educator, eventually became an eLearning developer, instructional designer. Most recently, before our reorg, I was with TeleHealth as an education manager. And here I am today as a senior learning business partner with the Learning Network.

Marc Harrison: You're like a millennial, you've had all these different jobs.

Kristen Bowles: I know, I know.

Marc Harrison: Isn't it great that you've been able to stay with this wonderful organization and grow and evolve yourself?

Kristen Bowles: It's been such a great experience. I feel so fortunate, not just for the jobs that I've had, but for the leaders, and for the friends that I've made along the way.

Marc Harrison: Yeah, I think it's those personal connections that are really special, right?

Kristen Bowles: Yeah, for sure. For sure.

Marc Harrison: So what would you like to talk about today?

Kristen Bowles: So the Learning Network, we have a vision of kind of changing the way education happens at Intermountain. Historically, it's been a lot of CBTs, you're probably familiar with our CBTs-

Marc Harrison: Yes.

Kristen Bowles: ... and classes, and a few other innovative things. But, we want to kind of switch so that we're doing more innovation and less of the typical stuff. So I'm just curious, when we talk about Intermountain as a learning organization, what do you think learning looks like for the organization as a whole, and also, what does it look like for individual caregivers?

Marc Harrison: Well, first of all, Kristen, you're going to be more expert at this than I am. So I am an open book and I'd love to learn from you. My sense is that I think about things in sort of two different buckets. One, are the things that I just have to learn, they're pieces of knowledge that are knew, that I have to incorporate into my armamentarium so I can be an up-to-date caregiver, and provide, in my case, administrative leadership, etc. But, in many people's cases, how are they an up-to-date nurse, or a pharmacist, or a finance person, etc. But, maybe more important than that, particularly in an environment where knowledge is doubling so quickly, I'm really interested in having us learn how to learn. Maybe even more important than that, for those of us who are leaders, like you are, how do we actually learn to lead people through change, and so that they keep learning? I guess that's how I see our organization, is that it's almost like a flywheel that picks up momentum, and good begets good, and learning begets learning, and competencies around leading those things gets stronger, just like muscles do, with exercising practice. You can tell me, am I way off base, or is that pretty good way of thinking about it?

Kristen Bowles: No, I really like that, and I especially like the idea of learning how to learn. Moving from a situation where everything is pushed to you, and we tell you when you need to learn and what you need to learn, to an organization and a group of caregivers who seek it out. They crave learning and they find it. We've just made it accessible for them, and we've given an opportunity to practice.

Marc Harrison: I think practice is a big piece of this. I think it can be very scary for people, some people feel a challenge is either a pass or a fail. For some people, that's stimulating, but for other people, it can be paralyzing, the idea that I may not live up to an expectation, or I may fail at something. I think that happens very rarely, and I think it's our job as leaders, to help support people, so the likelihood that they have a bad experience goes way down. What I would love is if over time, somebody has an opportunity to take on a big project, maybe a project that crosses traditional silos, which we've broken down, or maybe crosses geographies that didn't use to talk to each other very much. That they would have resources available to them to say, "Look, I'm a content expert as a pharmacist. But, I really don't know how to spread my pharmacy project across the enterprise. Can I learn how to lead that in a way that's effective and increases my likelihood of success. Then, how do I describe that to my leader, so that she or he can actually support me most effectively?" That's where I'd really like to get us. Does that feel good to you?

Kristen Bowles: It sounds amazing. There'll always be those pieces of education that won't be that cool. Right? There's the compliance matters stuff, but-

Marc Harrison: I'm really good at the fire extinguisher module now.

Kristen Bowles: Good.

Marc Harrison: I'm an expert.

Kristen Bowles: Good.

Marc Harrison: I point and sweep with the best of them.

Kristen Bowles: I won't tell you how closely I was involved in making that module.

Marc Harrison: Okay.

Kristen Bowles: But, yeah, I think that's exactly right. With One Intermountain the opportunity is to reach across the different matrices and learn from each other. Education definitely does not have to start in with the Learning Network.

Marc Harrison: The other thing I'll say, and I think your team is doing a nice job of this, but I think there's more that we can do, is that sometimes I worry that our caregivers who work in smaller or more remote places, have fewer opportunities and resources available to them, than if they're at one of our large community hospitals, or one of our teaching hospitals. I'd love to figure out how we can level the playing field. Some of that clearly will happen by distance, but there may be other opportunities that I think we should be mindful of, to move people around so they get great experiences, and have equal opportunities to develop themselves, regardless of where they are in the system. Have you given some thought to that?

Kristen Bowles: Some. It's interesting that you mention the small facilities. I had the opportunity to go to Sanpete yesterday.

Marc Harrison: I love going to Sanpete, as you may know.

Kristen Bowles: Yeah, they mentioned that they're ready for some more doughnuts.

Marc Harrison: Yes. Every time I visit, I stop at the doughnut shop and bring them doughnuts. Don't tell anybody, okay.

Kristen Bowles: Yeah.

Marc Harrison: All right.

Kristen Bowles: Your secret is safe. I was talking with their local educator and it's tough for them, because they don't have a lot of resources. They've had some opportunity to involve our simulation team. The sim team actually travels down there every once in a while and helps them out. But we need to help them. We need to help them do the best.

Marc Harrison: We do. On the record, I have affection and admiration for all of our caregivers. I think some of the folks who function in these frontier settings are particularly extraordinary. I've worked in those kinds of settings myself, and I really have a deep appreciation for how alone you can feel. You've got to be very creative and very resilient. I think tele capabilities have helped a lot. That's an example of leveling the playing field. But, I'd love to see their career and growth opportunities, and learning opportunities, mirror those of any of the other facilities too.

Kristen Bowles: Yeah, I'd love to see that too.

Marc Harrison: My sense is that sometimes people learn the most when the learning is "just in time," particularly clinically, because it's super relevant, right?

Kristen Bowles: Mm-hmm (affirmative).

Marc Harrison: I'm excited for us to use elements of behavioral economics, and nudging, and "just in time" learning, for our own caregivers, so they can develop themselves fully, and feel like they have some control and mastery over what's happening. It's just not being done to them, it's being done with them, and for them, and by them.

Kristen Bowles: And it's personalized.

Marc Harrison: Very personal.

Kristen Bowles: Mm-hmm (affirmative).

Marc Harrison: Yeah, there's nothing having somebody pull knowledge to themselves is much better than having somebody push it at them, right?

Kristen Bowles: Yep. Get it right time, right place, right amount.

Marc Harrison: Exactly. Are you starting to feel like doors are opening for you across the system so that you can make an impact?

Kristen Bowles: A little bit. I think we have a long, long way to go. We need to collaborate with everyone, right? Learning does not happen in a silo at all, it never should have, it never could before. So there's a lot more connections that we need to make.

Marc Harrison: I'd encourage you to make those. The other thing I'd really encourage, and this is sometimes a hard thing to do is, if a door is not open for you that you think should be, please be strong and strident in asking for that door to open, and you'll get help, because I know you believe in your mission. So in service of that mission, every once in a while, we have to get a little uncomfortable to make sure that you're getting what you need, because there's a lot of support for what you're here doing.

Kristen Bowles: Good.

Marc Harrison: I hope you feel that.

Kristen Bowles: I do feel that, I realize that too. Yeah.

Marc Harrison: So what question were you expecting? Go for it.

Kristen Bowles: I thought I was going to get to give you some advice.

Marc Harrison: Well, please, everyone gives me advice. Can you give me some advice?

Kristen Bowles: Well, first of all, I'll say thank you. This has been a great experience. I appreciate just getting a chance to meet you-

Marc Harrison: Vice versa, Kristen.

Kristen Bowles: I listen to your podcast and I think people enjoy them and they're learning from them.

Marc Harrison: Great. Thank you. So give me some advice.

Kristen Bowles: I've just become aware, because I interface with so many people and different groups, that the psych safety is a little bit lacking in some cases.

Marc Harrison: Me too.

Kristen Bowles: I'm not giving advice, I'm just asking you to keep modeling psych safety and keep modeling accountability for those things.

Marc Harrison: That'll be my pleasure. I think the psychological safety piece, that also is a practiced skill, to some extent. My sense is I can't grant you psychological safety. I can create an environment where you test and take some risks, and find that it is safe. But, it really is a two way street. It's not only something that a leader can do for somebody he or she works with, that's necessary, right? But, it's not sufficient. The other half of the equation needs to take accountability and try some stuff, and see what happens.

Kristen Bowles: Yeah, I love that.

Marc Harrison: So I really see this as a two way street. Leadership and growth and innovation are by nature, almost by definition, about relationships. They don't go in one direction.

Kristen Bowles: Agreed. Agreed.

Marc Harrison: What I'm hearing from you, in addition to giving me some advice, is a leader who is all in and is willing to try some stuff. What I'll do my best is to do my part. I'll be accountable and I'll try to create an environment where it's okay to be different, it's okay to disagree. But, it's never okay to not take good care of patients, and ourselves.

Kristen Bowles: Right.

Marc Harrison: Fair enough?

Kristen Bowles: Very fair.

Marc Harrison: Thank you, it's been a pleasure.

Kristen Bowles: Pleasure meeting with you.

Marc Harrison: You bet.