Like many organizations in the healthcare industry, California-based health network John Muir Health was particularly impacted by the COVID-19 pandemic. With 6,000 workers, many of them on the front lines of patient care, the company’s leadership quickly recognized the mental and emotional toll the crisis had on employees, says Lisa Foust, chief people and engagement officer.

The pandemic accelerated stress, heightening employee burnout and, ultimately, causing turnover to tick up, she says. Among the solutions, John Muir Health’s HR team partnered with the online coaching platform BetterUp to provide a range of coaching opportunities to build resilience in employees and development for leaders.

Since the partnership, the share of employees who rate their wellbeing as “good” has jumped 19%.

Foust, who joined John Muir Health in 2013 and previously served as CHRO of Citrus Valley Health Partners, recently shared with Human Resource Executive why online coaching was the right move for the organization and the long-term impacts she expects the health system to realize.

HRE: What was the day-to-day experience of the pandemic like for your employees?

Foust: What struck me was the level of fear, the uncertainty. Employees who work at the point of care, they really had a foot in both worlds: They were called by their own personal mission and purpose to be here for our patients, and yet, there was so much uncertainty in the early days of the pandemic about what they were leaving behind, and whether or not their families would be safe. It almost felt as though, while lots of the rest of the world went home and closed the door and maybe had their bubble of people that they interacted with, in healthcare, we just kept showing up every day, and that includes [us in HR], even though we’re not at the point of care. So, if we were nervous, it’s hard to even imagine what was going on in the minds of our frontline caregivers.

In those early days, it was about managing the fear. We tried to confront that with lots and lots of information; I think we probably erred on the side of overcommunicating—such as with subject matter experts—so our employees could calm their minds and the worries we knew they had about their families they were leaving behind when they came into work.

Once their fears about the virus itself were addressed, then it became about the relentlessness of the pandemic. And that was something that required a significant amount of effort on their part, including time away from the intensity of the care environment. [We focused on] that fear first, followed by a waning of that well of resiliency that typically comes naturally and easily to a caregiver. The pandemic really did a significant number on that.

HRE: How did those conditions drive the need for online coaching and the partnership with BetterUp?

Foust: We were an organization pre-pandemic that had very specific coaching resources embedded in our ongoing annual budget—but it was in-person coaching, where the individual would step away from their assignment, meet with a coach or a group to build up those resiliency stores or work on stress management or leadership. And then the pandemic comes, and we’re thinking, “OK, wow. We have to rethink our whole method of delivery.”

We have a pretty expansive array of demographics comprising our frontline caregivers: parents of young children, the sandwich generation, parents of school-aged children, folks with a spouse working somewhere else while they were sequestered here. All manner of opportunities to build resilience.

If you were somebody struggling with the fear element alone, you could select a coach who had a specialty in that. If you were concerned about how not to lose momentum with your child who was doing virtual learning for the first time, there were coaching opportunities for that. If you were struggling with maintaining your physical health, your diet, weight management, there were coaching services for that. For the first time ever, we had this completely customizable platform that then was delivered at the employee’s convenience.

They could just dial it up on their mobile device, do it at night, in between shifts, on the drive into work—anytime, anywhere. For John Muir Health, it was a complete and utter game changer. What we’ve learned from managing the resilience of our employees and giving them resources at their fingertips evolved into leadership coaching because of those same principles of convenience and customization—our leaders love it. And we have a higher level of subscription, we have a higher level of completion. We’re able to track those metrics to see that it’s truly making a difference in how they feel about their leadership skills.

HRE: What do you envision to be the long-term impacts of investing in leadership development in this way?

Foust: We have 430 people leaders at John Muir Health, and all of them are eligible for one of two cohorts of 50 we do at a time every year, where they have unlimited access to leadership coaching for a six-month period. What we’ve built up around that has provided some really lasting results.

We have a very lean organizational development and leadership growth department, anchored by one program director. This allows him to leverage being just one full-time employee. He holds sessions with members of the 50-person cohort every month, and he holds networking opportunities. We bring in senior leaders for sessions on “three questions with …”, and we’ve added debriefing sessions so all the leaders participating can learn from each other. People are developing professional networks that they didn’t have prior to joining in, and they’re developing subject-matter expertise aligned with our organizational goals.

[The BetterUp partnership] allows us to knit organizational concepts and goals together with what the individual leader needs in order to be the leader we need them to be. And it’s in a confidential, safe area where they can lean on their coach for their own personal needs.

HRE: How has John Muir Health’s approach to HR strategy changed in your time with the organization?

Foust: Our CEO has been on the job since October 2022, and people engagement has been in his top three strategic priorities for the entire health system. That’s a thrilling development. Now more than ever, if you don’t have an engaged workforce, you’ll fall short of your strategic priorities.

This is a people business, and we know it’s hard work; it’s getting harder every day. Our patients come to us far more acutely ill than they ever have before, and there are economic stressors that are ever-present. There are always financial pressures that cause a health system to have to choose this over that. But in this health system, how engaged employees are feeling about the work that they’re doing, how they’re being recognized for the work, how we’re communicating with them, how their leaders are engaging them—this is what gives you the competitive advantage.

We have a very highly regarded reputation for patient services, and the patient experience has everything to do with how employees feel about the work that they’re doing here. We try to lead the market for patient experience. And we also know that if employees are going to quit, they’re typically going to quit their supervisor or the way they were supervised. That explains why we believe in the investment in leadership coaching and employee resilience mechanisms in our benefits platform. Those are things that allow the employee to say, “OK, I feel valued here.”

HRE: What type of HR leader do you consider yourself to be?

Foust: HR leaders have to be relationship people. First and foremost, I’m a relationship person. The thing about the pandemic that really got under my skin is that I like to be in the presence of people; I draw energy from that. I think that people would probably describe me that way across the health system. And I have a really good memory. It’s important to me to remember who I’m interacting with, what their story is, what delights them.

That’s the kind of leader I’d like to cultivate here. If you do some correlations between top-performing departments, in terms of highest engagement scores, there’s a very high correlation between that kind of leader and high engagement.

Because everybody certainly deserves for their boss to know them, to know what’s important to them, to know what their struggles are. It’s not hard to do, and it’s not expensive to train for; you just have to make sure that your leadership team understands that that is one of the most important things that they do. Technical acumen? That’s easy to train for. But when we’re looking to hire people—particularly leaders—they need to have a high emotional EQ, they have to be great communicators, they have to give recognition freely and authentically.

I know that sounds like textbook material, but to me, it’s everything. It’s what I feel like I develop my reputation as a HR leader on. I don’t think I could be in a business that didn’t have me interacting with people all the time. I was sort of was raised by ”Ozzie and Harriet”; they were wonderful parents who instilled expectations that we are all—at all times, and first and foremost—supposed to be kind and compassionate people.

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