In this C-Suite Conversations interview, Lisa Abbott, EVP & CHRO at Boston Children’s Hospital, shares her perspective on leading through change in today’s healthcare environment. From supporting employee well-being to navigating hybrid work and embracing AI, Lisa offers practical insights on building a resilient, people-centered culture in one of the nation’s top pediatric medical centers.

Boston Children’s Hospital is one of the largest pediatric medical centers in the United States, offering a complete range of healthcare services for children from birth through 21 years of age. Boston Children’s is home to the world’s largest pediatric research enterprise and is the primary pediatric teaching hospital for Harvard Medical School.

Q & A With Lisa Abbott

Judy Kirby: I appreciate your time today, Lisa. You’ve been a CHRO for very prestigious academic medical organizations. As you’ve moved from organization to organization, what have you done to make each transition successful?

Judy: What is your advice on how to adapt when there is a significant leadership transition, such as a new CEO?

Lisa: You have to recognize that no two leaders are alike, and it’s our job, especially if you’re talking about a new CEO, to remember that we work for that person. We’re all intelligent adults and have our jobs because we’re subject matter experts. But at the end of the day, our job is to support the new leader, so we need to learn what that leader’s style looks like. We must learn what makes them get out of bed in the morning and adapt to their work approach as needed. Do not assume the new relationship will look the same as the previous one.

Judy: So there’s been a book out there for a while by Michael Watkins called The First 90 Days. Are you a fan, and what would you change about his advice?

Lisa: Is it 60 days? 120 days? I think the idea is to measure the organization you’re joining, and push the envelope enough without pushing yourself off a cliff. I’m a person who’s wired to make change, so I have to modulate depending on the organization I’m in. Some organizations want us to move quickly in certain areas. In others, we have to be more thoughtful in our approach. So the pace of change is governed in part by the change tolerance of the organization. That said, most people are averse to change, so you have to overcome that inertia at some point. But in my experience, it’s a lot easier to ask for forgiveness in the first 90 days than to get permission too much longer after that.

Judy: Amid all the uncertainty and looming changes, $340 billion in Medicaid, site neutrality, and so on, how are you dealing with the organizational stress people are feeling?

Lisa: We are in academic medicine, so we are in the crosshairs of every executive order that is coming out, whether it’s Medicaid changes, research funding changes or impact on visas. All of the things happening right now are heightened in academic medical centers. We have lots of students who come from overseas. We have lots of researchers who are paid from grant funding. Many of our patients are Medicaid recipients, so people are on edge. As a result, I think there has never been a more critical time to be really intentional about workplace well-being.

Are we ensuring that our community members understand all the support that is available to them? From Employee Assistance Programs (EAP) to financial planning assistance to paid time off to deal with these emerging issues. There are people asking for access to legal advice right now. What does that mean? So, holistic well-being has taken center stage, which we take very seriously. We’re bringing as much intentionality as possible to that right now, and it’s never been more important.

Judy: Everyone is trying to address physician and clinician burnout, but I recently came across an article about HR leaders becoming burned out too.

Lisa: Right. Anxiety doesn’t stop at the doors of HR. The people who work in HR are human beings, just like the people in the communities that we’re serving. We had an HR town hall meeting yesterday, and we talked about what’s going on in the world. We didn’t try to shy away from it. We talked about the organization’s commitment to upholding our standards and our values, but also emphasized that it’s really important, like they say on airplanes, to put the oxygen mask on yourself before you help your fellow passenger. I believe people need to take time out for self-care, and it is not selfish to do so.

One of the things that we try to focus on, especially in these days of remote work, is to make sure you check on your neighbor, a colleague who isn’t showing up the way they used to. “Is everything okay? You don’t seem like yourself.” Just asking the question and offering to help may be the support your colleague needs.

Judy: What are some of the well-being programs you have implemented for the employee population?

Lisa: We recently hired a Director of Well-Being. Well-being means different things to different people and has many dimensions. We’ve talked about mental and emotional health, but there’s also social well-being, physical well-being, and financial well-being, and we offer solutions in all of those areas. The challenge we’re trying to overcome right now is how to package it and ensure people know what is available.

Judy: During your time as CHRO, you have learned to deal with multiple generations of workers with different needs and priorities. What have you learned? What has worked and what hasn’t?

Lisa: That challenge has increased exponentially over the last decade or two. We see four or five different generations in the workplace. We have emerging workers who are technologically savvy but sometimes interpersonally limited. We have a more seasoned generation of people on the other end of the spectrum who are often lagging adopters of technology. They would like young people to work differently and have the same level of investment in their organizations and careers. When they don’t see that, they perceive it as negativity and laziness.

But the reality is that everybody brings value, and our more senior workers can be amazing mentors, leaders, and teachers. I see them helping the younger generations understand the history, but not living in the history, which is an important differentiation. It’s important to understand how we got here, but in the words of Marshall Goldsmith, “What got you here won’t get you there.”

Young people are the future, so we’d better be paying attention. We need to appreciate their technological prowess and the fact that maybe they have a keener sense of work-life integration. If we can be more purposeful about meeting people where they are as opposed to judging them for where they aren’t, we’ll all see more success in our workplaces.

Judy: COVID sent a lot of people home to work remotely. Some organizations are bringing everybody back on-site, while others are making hybrid and remote work permanent. How are you dealing with that at Boston Children’s, and how does it affect promotions?

Lisa: I’m not sure anybody has the right answer on this. Jamie Dimon has a strong opinion on this and JP Morgan Chase is bringing everybody back to work on site. He talks about the impact on future generations of leaders, and I think he’s right about that. I think that there is real value to incidental contact, that proverbial water cooler chat, or the chance to pass a leader in the hallway and have an impromptu conversation or ask them for career advice.

On the other hand, we have benefited enormously from the ability to attract a much more geographically dispersed population of employees. Plus, some roles are very well suited to being remote, like corporate services roles, some HR roles, IT, and finance. If we, in Boston, were to say everybody has to come back to work, we’d lose a large part of our workforce, not just because people have appreciated the ability to be remote, but because Boston is a really expensive city. It’s expensive to live here. It’s expensive to commute.

You really have to weigh the pros and cons if you’re deciding on anything other than a hybrid model. I imagine Jamie Dimon will see a downward blip on the radar at JPMorgan Chase, because it will take a while before they can start staffing up with people who are proximal to where their banks and offices are. In Manhattan, they have the same problem we have here in Boston. You lose hours of your life just trying to get to work.

Judy: Some positions cannot be done remotely, like surgeons. What have you implemented to get the talent you want to move to Boston, considering the high cost of living?

Lisa: We pay a premium for our geography. That’s just the reality. In cities like Boston, New York, and San Francisco, you pay a geographic premium on top of what the job would be valued at in the Midwest, for example.

The Harvard affiliation is really attractive to people. We are a teaching hospital of Harvard Medical School, and that matters to people. They want to be affiliated with the institution. Many of our clinical colleagues and physicians were trained here in the Harvard system, and I hear a lot of comments about how glad they are to be back. It feels like home.

But we really try to make sure that the job is right for the specific individual, especially at the executive level. As you know, executive turnover is expensive, so when I’m working on an executive search I pay a lot of attention to what the family unit looks like and what their needs are – whether there’s an accompanying partner or children or pets or in-laws.

Judy: Have you implemented effective testing and interviewing techniques to ensure the right person is hired in every position?

Lisa: Everything we do is a data point. We do our best to think about not just the job description and whether the person can do the job, but the leadership competencies that the person needs to bring for the time we are in and, more importantly, for the future. A leader four years ago is a different leader than what we need today, dealing with massive uncertainty and change. It’s not for everybody. We certainly do the aptitude assessment tests, but I’ve had people interview extraordinarily well and pass their Hogan Assessment with flying colors, and then still fail. There is no silver bullet.

Judy: How are you using AI, and how do you think it will affect you and your team over the next few years?

Lisa: I was in IT before I was in HR, so I’m all about freeing up human beings to deal with real problems, not transactions. For example, we’ve used AI to automate the nursing licensure renewal process, which had been exceptionally manual and arduous. No one is complaining that AI took away their grunt work of manually digging for primary source verification.

I’m all for it, and our younger employees expect it. I’d like us to become more proficient with automation and AI. Not everybody feels that way. It can be pretty scary, but there’s only upside for people willing to learn and be upskilled. Yes, your existing job may go away, but we will create a different role for you where you are doing even more valuable work.

Judy: Throughout your career as an HR leader, how have you collaborated with other departments to enhance their culture?

Lisa: We do this in various ways. When you’re on your listening tours, you start to figure out where there are challenges, where people aren’t interacting as we would want them to, and so forth. So, we use observational information, and then sometimes people will raise their hand and say, “Our team needs a shot in the arm. What can you do to help?”

We use our Press Ganey survey data and have partnered with Chartis to gather data on burnout and resiliency in the workforce. We also do what I would loosely call “interventions.” We figure out the problem they’re trying to solve, where the obstruction is coming from, what the leader is like, what the leader wants, and help them create better interpersonal and team dynamics.

I want people to bring their very best selves to work. But more importantly, I want them to bring their very best selves back home because that tells me that they’re engaged, feel valued, and that their work matters. That feeling is tied to how well they get along with their colleagues and their leader. A big part of that work is teaching people how to resolve conflict because the ability to resolve conflict is a key driver of a favorable culture.

Judy: What work have you done to strengthen the IT culture? That’s a group with a high proportion of remote and hybrid workers. We’ve heard horror stories of people taking on two or three jobs while working from home.

Lisa: I believe it. You hit on a key example, the tech roles, but I also think about medical coding and billing. Those are jobs that people from all over the country do and lend themselves to multiple potential employers. So, if hybrid or fully remote work is something that you plan to continue, it’s incumbent upon you the leader to work harder to engage the people who aren’t sitting next to you. Isolationism is not necessarily conducive to teamwork without an extra level of investment. It requires very deliberate behavior, and it is hard work.

Judy: So, you have remote workers all over the country. Has that been the case since COVID?

Lisa: I’ve been at Boston Children’s for two and a half years, so people were remote when I got here. I’m still regularly asked, “Are you taking away remote work?” As if I have the power. But I’ve heard leaders in our organization say, “I want to take away remote work as an option. I want my people back.” To that I say, “You are empowered to make that decision for your work group, but I’m cautioning you, you will lose people, and you have to be prepared for that.”

Judy: What career advice do you have for professionals interested in becoming a CHRO one day?

Lisa: The first thing I tell people is, “learn how to speak the language of the client you’re serving.” I’ve learned that myself. Nobody wants to hear FLSA, wage and hour law, fair labor, OSHA, and all the acronyms. They don’t care about that. They care about P&L, patient populations, and adjusted occupied beds. They care that we understand their strategy as a department within the business we’re in – and that business is healthcare.

Judy: What else?

Lisa: It’s important to learn the varying aspects of HR and understand that we are the compilation of a bunch of different functions. Employee relations is very different from benefits which is very different from compliance. Another thing is that it is really important to have thick skin. We deal with a lot of really complex people problems, things that can sometimes make you feel bad about the human condition. If you’re overly sensitive, this is not a great job for you.

You have to be able to discern the truth in a lot of storytelling. People will come to you with big stories, and when you start to dig a little deeper, you find that there’s an element of truth to that story, but there’s also another side. So you have to have impeccable judgment, a little bit of a poker face, and the ability to take information in and not necessarily react in the moment.

And lastly, you really have to possess the ability to be discreet and to hold information in confidence. This isn’t the old days of the personnel department. CHROs are integral consultants to the CEO and the executive team. Since COVID, the value of human capital and the people that lead the human capital function have become recognized as equally critical to every other resource, so we have an obligation to own that responsibility in a really deliberate way.

Judy: What are some things keeping you up at night right now?

Lisa: Right now, it’s the external environment. Like I said, we sit in the crosshairs of so many of these executive orders, and I worry about the impact on actual people. When we lose grant funding, there are people at the end of those transactions. When Medicaid cuts happen, there are patients at the end of those transactions. I want to do everything we can to ensure we continue to deliver the extraordinary care that we are known for at Boston Children’s and that the people delivering and supporting that care feel safe, feel valued, and still have a paycheck. So that weighs on my mind regularly. I wake up daily wondering how many more shoes will drop and who they will impact. So, we’re doing the best we can in this uncertain time.

Judy: What do you enjoy doing in your free time?