 Hi, I'm Rusty Komori and this is Beyond the Lines on Think Tech Hawaii. I was the head coach of the Punahou Boys varsity tennis team for 22 years and we were fortunate to win 22 consecutive state championships. This show is based on my book which is also titled Beyond the Lines and it's about leadership, creating a superior culture of excellence and finding greatness. My special guest today is an extraordinary man who is the highly respected president of Queen's Medical Center and he's also the chief operating officer of Queen's Health Systems. He is Jason Chang and today we are going beyond medical care. Hey Jason, great having you on the show today. Hi Rusty, thank you for having me, it's such an honor to be on. Now Jason, I want to know about your youth growing up. Did you grow up in Hawaii? Yeah, you know I look like it, I've been asked many times what high school I went to, but I'm actually from Fresno, California, born and raised. Closest ties are my grandfather who was a Japanese, part of the internment camps and then 442, so a lot of friends that came from Hawaii. Wow, so are you Japanese and Chinese? I'm actually Japanese and Korean, half and half. I think my grandparents on my father's side came over and it's more phonetic, but Chang is kind of a universal name. Well you and I are both Hoppa because I'm half Japanese too. Now Jason, what jobs did you have prior to joining Queen's? Yeah, I've been very fortunate, so my career has really been in healthcare administration, so I've really done nothing in my entire career other than run hospitals, from the very low levels of managing departments and working on the front line, and then progressively became associate administrators in hospitals in California. One cent took me out to Texas and that's where we realized that I have to find the place that I'm going to live the rest of my life and that now is Hawaii. We love it and I'm quite fortunate to be leading this wonderful organization. Well, I think we're all happy to have a great leader like you here in Hawaii and Jason, I want to talk to you about my books. You know, I have my new book that just recently came out beyond the game, but in both books I talk about how great leaders prepare for everything and anything that can and will happen. And I want to know how prepared were you and your team for this pandemic? Well, I'll tell you, we had a little bit of advanced notice because New York went through the pandemic first and then it started to get closer to home when Washington struck and so we had a little advanced notice, but I don't think anybody anticipated the true impact that COVID was going to have. I mean, you read it in the stories, you watch it on the media. Sometimes we think that those stories are exacerbated and so at first here in Hawaii, I think we were quite surprised at how virulent the virus has been. So, you know, I think that the team has been amazing because they responded very quickly, but at the same time, we're learning every day. We've learned more about the virus and we're learning more about how to procure equipment and supplies and everything else that we need, but we've come a long ways in five months. So how are you and your staff coping with the pandemic so far? So far, so good. I think that I think it was harder early on because it was such an emotional wave. People wanted to protect themselves. They're worried about their families. They still had a responsibility here in the hospital. I'm really blessed. Our physicians and frontline caregivers, they put the patients first all the time and so never a question about should I come to work, right? Am I not going to come to work? So those people are the ones that get so much credit, but today I think we're in a much better place. We know that we can be safe if we wear the proper PPE, if we social distance, and that's not just in the world outside our walls, it's inside of our walls as well. And some of the therapies are starting to work, helping people get better. We don't have a vaccine or a real defined treatment, but some of the traditional treatments are showing progress. So Jason, what have you been learning like how you said that you're learning more and more every day? What are some things that you've learned now versus when the pandemic first started? Yeah, I think that isolation is the number one thing. So identifying the patients using testing and we have access to more tests than we've had ever in the past, but we still need more. And the second part is once you identify a patient, how do you get them isolated so that you can take care of all the other patients that need your care? It's interesting that so much attention and so many resources are going towards COVID today, but it actually represents less than 5% of our total population of patients getting care in the hospital system. So you have to identify them, get them isolated so that the other 95% of your patients feel confident and safe getting the really important care that they need. These are stroke patients and heart attack patients that in March and April delay their care. And so we saw patients that typically would have, you know, called 911 and came in delaying it. And then now they're seeing more secure or more acute heart attacks and other symptoms. So we want education to get out there as broadly as possible that if you feel some symptoms, if you feel like something's wrong, call 911 and get care. Jason, when the pandemic first started, you guys set up a bunch of the decontamination tents. Can you tell me about that? Yeah. Absolutely. So it's a landmark day for us. March 13th was the day that our president declared COVID a national pandemic. And that's the day that we put up our tent. And it really served as a beacon to our entire community that Queens is here. We're making the investments to take care of the population in any way that we can. So we had people that worked in our emergency room primarily staff the tent, but it was 24 seven and people just literally dropped what they were doing. Volunteered to be swovers and then, you know, just picked up the shift and went. It was amazing. There was a date in May when we said, you know, we have to get used to living with COVID. We can't be just responding. And so we took it down and it made the news and it was almost like the beacon of light had kind of come down and we're trying to reinstall in the community that just because the tent comes down doesn't mean we're not here to take care of them. We actually found more permanent structures so that we're not operating out of a tent. But that was, you know, a landmark day on March 13th. Yeah, I totally agree with you. And you have a bunch of various locations of your medical centers. Can you tell me about the various locations that you have and how you're keeping everybody on the same page? Yeah, you know, we've expanded the health system tremendously over the past even year. So Island Urgent Cares became part of our O'Hana. We've opened up clinics in Kahala and Empower Health over in Kapolei and Eba. And all of those locations are there to respond to COVID, whether it's the physicians that can see the patients and order the tests to all the Island Urgent Cares where you can get a swab and not even get out of your car with the order. And then our emergency rooms are there for anybody to come through. But I feel like we've done a good job expanding our locations, improving access so that anybody that needs the care that it's there for them doesn't doesn't matter if it's the very low acuity to the very, very, very severe. Jason, how proud are you of your doctors and nurses and your entire staff during this unprecedented time? They are amazing. And literally all the credit goes out to them. We have people that have, you know, put their families on hold. We have stories of our caregivers sleeping in their garages so they didn't potentially infect their family members, but then would wake up every day, come to work, smiles on their faces and do the work that they needed to do. And many times they were changing their jobs and changing their typical responsibilities because it's what was called upon them. So the credit goes out to all of them. I can't thank them enough. And the community has been so loving. The aloha that they've shared with their gifts really shows that they appreciate the work that they're doing. Jason, what are the silver linings? As bad as this pandemic and this virus is, what do you see as the silver linings? So there's a couple of things I think that are going to be real silver linings. The first one is telemedicine. We have seen in a tremendous uptick of telemedicine visits. And this is something that we thought we were doing a good job, slowly growing, you know, three to five percent year over year. So in May, we saw 14,000 telemedicine visits. And that's from January, we would see about 200 telemedicine visits a month. So to go from 200 to 14,000, it's incredible. And I think it's a way for us to get primary care and specialty care out to not only the people here in Oahu, but everywhere in any rural community that needs our care. So that's the first one. I think that there's a couple more silver linings out there, too. I think people have also realized that we can prevent things like flu. So infectious diseases that if we wear masks, we wash our hands, we make sure that we stay healthy and we can take care of our community in ways that demonstrate that we're doing it better than anyone else in the nation. I like hearing that, Jason. And Jason, another thing that I really I'm so impressed with is your Queen's employees donated over $83,000 to our Hawaii Food Bank during this time. Tell me about that and how that makes you feel. That is an amazing story. And one that our caregivers did on their own. So at one point, they had been receiving food donations, masks that were made. We had flowers that were donated from many of the different local florists. And at one point, they said, this is amazing. The community is showing their Aloha for us. We need to pay something back to them. And food insecurity is one of the highest variables when it comes to social determinants of health. And so we started a small campaign and it was our physicians that started it. And they've raised the first half and said, you know, we challenge the rest of the organization to meet the other half. And so the second 40,000 came from all the frontline caregivers that are out there across our entire system. And we were more than surprised when we generated $80,000 and we're able to contribute that back to the food bank. Well, that is just so impressive. I mean, that speaks about, you know, the character of your employees. I mean, I'm just I'm so touched when I when I saw that. And you you were receiving a lot of masks donations, you know, from from individuals such as pro baseball player Tsu Yoshi Nishioka and Uniquelo Hawaii and the Kawakami family at Iolani Clothing and Allison Izu. I mean, it's so amazing that these people, you know, step up. How do you what does that make you feel like when the community is stepping up to help with these masks? Yeah, thanks for that question. I think that, you know, one, it makes us feel like our frontline caregivers are loved you know, just to receive the donations. And we made a public cry out for help. When we said we are trying to procure 95 masks, visors, face shields, gloves, all the things that we need to keep our caregivers healthy and protected. And we're having a hard time procuring from all of our traditional sources. And the community stepped up all of a sudden. We started getting visors and face masks from all of the different schools, companies that went way out of their way to start just sewing and making and creating and procuring for us. And that sentiment is just one that, you know, touches my heart because it's communities taking care of communities, our people taking care of our people. And that that's the strongest and most wonderful part of Hawaii. Jason, you know, I want to ask you about contact tracing. You know, are are you guys doing contact tracing? And is there a software that you guys are using? So we do do contact tracing and we start with our own employees because we do have exposures that happen within the hospital. Good example, patient comes in with asymptomatic presentation. So you start to treat them for their immediate need. And it could be a stroke. It could be a heart attack. And then after a few hours, you realize that the patient turned out to be positive. So we have people in our organization that do the contact tracing. It's not enough people. It's not enough people. And so I, you know, bless their hearts and really want to praise the work that they do. But tirelessly, doesn't matter what day, what time, but they contact everyone and ask the right questions. And then we work with the Department of Health. So we don't do any contact tracing outside of our walls, but we completely support with the testing and then getting information to anybody that feels like they've been exposed and doing our part to help with that contact tracing. There is a telephone line, which is 691-2619, which is really an info line that's meant for anybody. You don't have to be part of Queens. You can call it. You can ask any question that you want. And we contact and are coordinated with the Department of Health and Hyema to make sure that that is a very valid resource, open line of communication and that the communication is all shared. Jason, what are the financial effects this pandemic is having on your medical centers? Yeah, that's been a tough one. So in May, we had a loss of around 40 million dollars. And that's really because we were putting out a lot of expenses to make sure that we were standing up, getting the right equipment, buying all of the PPE that we need and doing so in ways that we could stockpile and be prepared for the future. What we're looking at into the future over the next year is approximately a seven million dollar negative impact, so seven million dollar a loss per month over the next year. And we're hopeful that as we get towards the end of that year, we have our arms around COVID. There's a treatment in store, potentially a vaccination. But we're hoping that the recovery that the entire state needs reaches us as well. Well, Jason, you know, I think everybody just thinks that, you know, the medical centers are doing well because you guys are so busy, but it's it's having, you know, the opposite effect actually, right? Yeah, you know, you know, the interesting thing is that there's a lot of people that are afraid to come to the hospital. They want a social distance. They feel like they're safer at home and we completely support that. But a lot of our caregivers, private practice physicians in particular, they make their living, seeing patients in their office and doing procedures. The impact has been a decrease of about 10 percent or so, depending on the area. And our emergency department has seen about a 25 to 30 percent decrease in its volume, both at the West ER and our Punchbowl ER. And I think that other hospitals around the nation are experiencing something very similar. So we know there's an economic impact, but hospitals are meant to take care of the communities. Our commitment is that we'll be here for them no matter what, twenty four seven, three hundred and sixty five days a year. So we will do everything that we need to. It's part of our Kuliana. It's our responsibility to be here to keep you safe and keep all of our employees safe as well. So we will continue to do that. Jason, what other important messages do you want to share with our community? I think the most important thing is that you can each individually impact covid. So what we're seeing is that these hot spots really arise when people are not wearing the right personal protective equipment. So you're not wearing a mask, you're not wearing goggles or visors. You're not practicing social distancing or washing your hands. And so the number one way to protect each other is to practice. Aloha, wear a mask, wash your hands, socially distance and be responsible. It really does play an impact when you look at some of the recent holidays and then typically ten days after this, when you see the increase of positive cases, it almost is like clockwork. Each holiday that we have, every time that there's a holiday weekend where people get together, we see a spike up on the positive cases. So it just proves that if we can do our due diligence, make sure that we stay away from each other and protect each other as much as possible. Then we can have a definitive impact on one covid. I look at other states like Florida and Texas where they started to open up too soon. People decided that they had enough of the rules and being anti-social. And you're seeing that their average median age of positive cases is somewhere in the 29 to 30 age range. And so it's a younger population, but their spread has become uncontrollable. And so that's my biggest fear. And my plea to everyone is that we're doing the nation's best job. We are the number one in the nation at keeping prevalence down. And we can continue to stay in that position if we all are being socially responsible. Jason, so let's let's think positively. Now, when a vaccine is found, how how easy is it going to be for you guys to distribute it? And, you know, what are the capabilities that you have to to really get it to the public quickly? So I think the the fear I have is that we're not going to get enough. And that's always the case when something is just manufactured, whether it's the test, the antigen or a potential vaccination is the ability to procure enough that we can make a meaningful impact to all the people of Hawaii. And so I think it'll be in some ways we'll have to figure out who gets the test first or the vaccinations first. Maybe that's the elderly or the vulnerable populations, but we'll continue to work with our congressional delegations and everyone possible to make sure that we get our fair share of the test. You know, being out here in Hawaii and being the number one state at reducing the prevalence. Sometimes, you know, those legislators up in Capitol Hill feel like, oh, you know, Hawaii doesn't necessarily need the test right away or the vaccinations right away, but we have to fight and make sure that we get our fair share of the allocations. Jason, I want to ask you this. You know, you've been a very successful leader wherever you you have gone to. And I'm just so happy that you're here in Hawaii with us now. What what is your leadership style like? Yeah, you know, I've been very blessed over the course of my life to have tremendous leaders, those role models and mentors that have challenged me and put me in positions to think autonomously and grow. And so I feel like I need to pay that back. And so I really try to take on a mentoring position with all of our leaders here within the organization. I like to be collaborative. I think that we need to challenge each other and push and make sure that the way that we think isn't necessarily always the right way, but we can help improve as a team and walk out on the other end with a unified decision that's the best for the organization. So I try to keep things collaborative. Want to make sure that, you know, everyone feels like in within my presence and the presence of my other leaders, that everyone's heard. We want to be able to listen and take into consideration you know, the thoughts and ideas that everyone has. And if you can support that, I think you can create an amazing team. You know, I always say that great leaders always build other great leaders. And that's exactly what you're doing and exactly what you had said right there. And I want to ask you still about leadership, you know, what have you learned about yourself today versus Jason 10 years ago? Yeah, you know, it's been quite a journey. And I think that you're always on a perpetual pursuit for growth. And 10 years ago, I would say that, you know, I was working in the for-profit world. So my health care system was tenant health care, have over 200 hospitals, all for-profit, publicly traded across the United States. And it was much more aggressive. You know, your priorities tend to be different, you know, based on who your employer is. And I've learned so many lessons. I think the number one lesson I learned back then was that in the for-profit world, I can offer a dollar and my employer will take that dollar and say thank you. But I have a responsibility as the leader of that hospital and a leader in that community to say you have you have the ability to take this dollar. But that means that this is going to happen. These are the sacrifices. These are the consequences. And I think they respect that because, you know, if you provide really, you know, an honest understanding of what those impacts are potentially going to be, those are huge investments those companies have in their hospitals and those communities. And so they want to make sure that their reputation, their ability to provide quality health care is as high as it can possibly be. And so, you know, it's not always about the dollar. So when I look at, you know, my position here and what I, you know, am doing at Queens, I'm really honored because our mission is so strong. I've never worked in an organization that was so committed to the people of Hawaii or the people that know that it served. And I hope that, you know, the things that I've learned over the course of my career around financial management and growth and strategic planning can translate to making Queens the best place to take care of all the people of Hawaii indefinitely into the future. So, Jason, what kind of culture of excellence are you striving for to have with your team at Queens? Yeah, I think that the first one is the culture of communication. That's the most important to me. I feel like if people feel that there is, you know, retribution or a punitive environment and people sweep things under the rug and we're in an industry that you can't do that. If there's something that's going to put a patient in jeopardy, we need to know right away so we can make things better and fix it. Because nobody in health care went into health care because they want to hurt anyone. Everybody wants to help, you know, their fellow peers or all the patients that we are blessed to take care of. And so I think the communication is the most important one. And I think the other is, you know, creating a culture of transparency that in the world of health care, there's many things that go wrong and there's many things that go right. And that's the beauty of what we do every day. And if you're transparent about what's good and you're transparent about what's bad, everyone knows we're headed. Everyone can buy into the vision and everyone can help pull their weight and get us to that goal faster. I like hearing that about communication and transparency. And Jason, besides this pandemic, what's a big adversity or a big challenge that you had to deal with that you overcame in your life, whether it be personally or professionally? Yeah, you know, there's always a tremendous amount of adversity anybody has, you know, over the course of their journey. And I've had, you know, my fair share, definitely. I think that, you know, some of them have been, you know, really understanding organizational cultures and how corporations value communities and each one is going to be different no matter where you go. But, you know, I've learned that not all things are altruistic, you know, as you would expect them to be or wish for them to be and have had to make hard decisions. And sometimes, you know, early in your career, it's easy to make you know, decisions that impact your personal life because they don't align with your values. But, you know, as you got married and had a family, all of a sudden those decisions weigh much heavier. And so I think the good thing is that, you know, it gives you a chance to reflect if you can pull yourself out of the weeds and look at it from, you know, a higher vantage point every now and then. It gives you a chance to understand what you personally value and what personal decisions you have to make in order to, you know, be fulfilled and make meaningful contributions to a community, to your family and, you know, everyone else that you care about. I like hearing that, Jason. And, you know, you mentioned about mentors earlier. What's the best advice you ever received? The best advice came very early on and it was don't be afraid to get thrown from your horse. And it's one that came to me and it's taken years to really understand what it's like to get thrown from your horse. So we can go through lots of hypotheticals on what it's like to be terminated, to go through hard situations, to have to make hard decisions, but until you're really thrown from your horse, where you get the wind knocked out of you and you have to dust yourself off, and sometimes your ego gets bruised and sometimes, you know, it's painful and, you know, the emotions really settle in. All of a sudden it's a different situation. And if you're able to get thrown from your horse and then recognize what you need to do to recover, one, get back on your feet, and then two, learn, you know, why did you get thrown from your horse? I think that that actually will go a long ways in the development of anybody. And it was an early mentor of mine that said, hey, you know, you got to get thrown from your horse. And it took me a while to figure out what that was like. But once I got thrown, and now I've been thrown many times, it stuck with me. Well, that's when we learn a lot about ourselves, right, Jason? Very true. You learn so much about yourself, you know, during bad times, much more than you do during the good times. Hey, Jason, I want to thank you for taking time in your schedule, you know, to join me on the show today and really sharing, you know, some updated insights about the pandemic as well as, you know, why you're a successful leader and how how you're really building other great leaders. So really want to thank you. Now, thank you, Rusty. This has been an honor to be on your show and just share a little bit about the journey that I've been able to enjoy and that Queens is on. So thank you so much. Thank you, Jason. And thank you for watching Beyond the Lines on ThinkTech Hawaii. For more information, please visit RustyKamori.com. And my books are available on Amazon and Barnes & Noble. I hope that Jason and I will inspire you to create your own superior culture of excellence and to find your greatness and help others find theirs. Aloha.