Most healthcare leaders treat chaos as something to eliminate. Daniel Hudson, MSN, RN, CENP, SVP of Nursing Operations at Jefferson Health, argues the opposite — and he has built a system around it. Drawing on quantum leadership theory and more than twenty years in nursing, Daniel makes the case that chaos is not a failure state. It is the precondition for evolution. “Our job as leaders is to recognize the chaos and understand how to shape the chaos, not to remove the chaos.”
Red isn’t about failure. Red is about information.
The Chaos: Healthcare leaders are operating inside compounding volatility: executive orders arriving faster than anyone can interpret them, AI disrupting every corner of the industry, workforce variability that swings from overstaffed to dangerously short in a single day. Jefferson dealt with a hospital fire and a hospital flood inside twelve months. Underneath all of it sits a harder problem — organizations that have been trained to hide red. Daniel points out the asymmetry plainly: when red shows up in safety and quality, healthcare investigates it to the core of the earth. When red shows up in operations or finance, no one runs the five whys. Leaders are then making decisions on assumptions and, as Daniel names it, fake realities.
The Leadership: Daniel’s answer is to run VUCA against VUCA. The environment delivers volatility, uncertainty, complexity, and ambiguity; the leader answers with Vision (constantly reinforced direction — “everybody needs to be going forward”), Understanding (root cause work, fishbone diagrams, real inquiry), Clarity (who is responsible, who is accountable, who is genuinely the decision maker and who only thinks they are), and Agility (no decision is ever final, because the system never stops evolving). He pairs it with a second framework — strategy, structure, process, people — and a governing belief that 95% of the time the problem is the system, not the person.
The Success: That discipline produced Jefferson’s nursing team: elite nurses deployed across regions like a special operations unit, with tiered deployment models, compensation built to match the ask, and enough flexibility to serve 900-bed academic hospitals and 10-bed micro hospitals alike. Seventy nurses were hired into the new Lehigh Valley region since January. But Daniel is direct about the real lesson — it was never a staffing fix. It was a systems challenge, and the hardest part was ownership: who owns which part of the process, and when.
Why Listen: This episode gives leaders a usable operating system for environments that will never stabilize again. If your organization treats red as an indictment rather than information, this conversation is a blueprint for changing that.
Interested in leadership perspectives from across healthcare? Check out all of the Success in Chaos episodes! New content comes out monthly.
Episode Chapter Guide
02:53 Daniel Hudson’s Leadership Journey and Systems Thinking
07:58 Understanding VUCA and Chaos Theory in Healthcare
12:35 Applying VUCA: Volatility, Uncertainty, Complexity, Ambiguity
20:35 Building Adaptive and Flexible Healthcare Systems
27:37 The Role of Red Data in System Improvement
32:45 Leadership Culture: Red Is Good and Change Realization
39:33 Leadership Style: Curiosity, Courage, and System Ownership
43:23 Future Skills for Healthcare Leaders: Curiosity and Courage
Full Transcript
AI-generated transcript. Accuracy may vary; please excuse any transcription errors.
[Cold Open]
Daniel Hudson, MSN, RN (00:00)
One is that chaos must be present in order for a system or systems to evolve. So I want you to think about that for a second. We react to chaos. We say, stop it, get it out, it can’t be here. But the reality is we need it. We need it to learn. We need it to understand how it’s impacting all the other systems. So it’s important. Our job as leaders is to recognize the chaos and understand how to shape the chaos, not to remove the chaos.
Angela Adams, RN (00:30)
And I would agree. Remember, Kandice, several people in a row used COVID — the chaos around COVID — as a launch point. They say COVID was the best thing that happened to their org. So it’s your same thought process here: you must have chaos in order to create the system’s evolution. I love that.
Daniel (00:50)
That’s right. And this is based off quantum physics, right? That’s the cool part.
[INTRO]
Angela (01:02)
Welcome to Success in Chaos, a healthcare podcast where each episode is dedicated to unlocking success amid rapid change and uncertainty. I’m Angela Adams, the CEO at Inflo Health.
Kandice Garcia, RN (01:13)
I’m Kandice Garcia, owner of Tungsten QI Partners and quality director for the ACR Learning Network. Our guest today built one of the most talked-about nursing workforce innovations in healthcare: a team of elite nurses deployed like a special operations unit to wherever Jefferson Health needs them most. But underneath that program is a leadership philosophy worth understanding — a military-inspired framework called VUCA, a strategic planning discipline he treats as a living operating system, and a culture where red isn’t a warning sign, it’s an invitation. Daniel Hudson, SVP of Nursing Operations at Jefferson Health, welcome to Success in Chaos.
Daniel (01:56)
Thanks, Kandice and Angela. I’m just excited to be here to share not just my story, but our journey here at Jefferson Health.
[ORIGIN STORY]
Angela (02:05)
We are so incredibly happy to have you on. When we heard about the systems you had put in place, truly, it’s unique out there, so we wanted to get the word out. On Success in Chaos, we love to highlight the individuals Kandice and I run into on the daily who are driving success, and we especially love finding people doing it through process, quality, and systems thinking.
We first want to start with your origin story. You’ve built a career around the idea that healthcare leadership needs a real system, not just values on a wall. Where did that belief come from, and how has your leadership philosophy evolved over your different career shifts?
Daniel (02:53)
My leadership journey certainly hasn’t been linear. It’s really been a journey from one-time interactions with patients to understanding how all of the systems we operate in are connected. That started when I first got into healthcare as a nurse extern in the ED, as a trauma tech. That’s where I was treating patients one by one, absorbed in the chaos of an emergency department.
Angela (03:28)
That’s definitely chaos right there.
Daniel (03:31)
Right topic for us to be talking about. I graduated from undergrad and started my nursing career in Tennessee in an ICU step-down unit as a nurse resident. About a year in, I went to travel nursing.
Angela (03:52)
Good money.
Daniel (03:53)
Well, let’s be clear — I did travel nursing before it was the cool thing to do. I’ve been a nurse now for over 20 years, so I was doing this back in the early 2010s. One thing I started to see as a travel nurse, going to different hospitals and different units, was how the same problems existed everywhere. I started getting curious: what are these problems, and why are we having them? I once heard a quote about nurses and workarounds: don’t get mad at a nurse for a workaround, because they’re really innovating.
Angela (04:35)
Exactly. Little engineers.
Daniel (04:38)
Right, we’re just little engineers running around the healthcare system. That’s where I really started to learn that it’s all just a bunch of systems. I started to see those systems and how they’re connected — the challenges of systems, but also the beauty of them.
I did that for three or four years, then settled down at the hospital where I’d started my travel career, in Los Angeles, as a night shift charge nurse with administrative functions.
Angela (05:10)
Also chaos.
Daniel (05:12)
Chaos. That’s where I started getting more into leadership and understanding its dynamics. One thing led to another, and I became a nurse manager — and opened a unit as my first job as a nurse manager. Everybody drops their jaw at that. It was my first true leadership role, fully engaged in building the systems needed to open that unit. I did that for several years.
Then I had this moment of, I want to understand these systems more. I got curious about how I could do that even outside of nursing, and I had a wonderful opportunity to help open a care redesign department — the Value Improvement Department — at that same hospital and health system. That’s where my mind really exploded around the idea of complex adaptive systems. I learned about lean healthcare and how you break down and redesign systems. That’s the foundation of my learning around systems.
Then I went on to get my graduate degree, and my entire focus was complex adaptive systems. In my graduate program, I did something really cool: I took a theory called quantum leadership theory, which is based on quantum physics, and applied it to my leadership. That’s where it all bloomed like a flower and grew like a garden, and ever since then I’ve focused on systems.
Certainly there are times when you have to address people and behaviors, but 95% of the time it’s a system problem. There’s chaos within that system — uncertainty, complexity, ambiguity — the VUCA we’ll talk about soon. That’s the journey I’ve been on for 20, 22 years now. So I guess I’m no longer a teenager.
Angela (07:32)
No, you have grown up. You’re now in college, master’s, doctorate. It’s interesting you say that — I was in a conversation the other day, and I hope you know what an absolute treasure that skill set is: recognizing not only trends across a system, but also that there’s a systems component that can fix it.
I was sitting with some friends, all physicians, complaining about a very specific workflow they all had. Of course, that night I couldn’t sleep, so I designed the product and showed it to them the next morning — we were on a little retreat together. They said, “We’ve been complaining about this for two years. No one has ever fixed it.” So Daniel, kudos to you, because very few of us see a problem, fix the problem, and put a system in place to make it scalable. I applaud you on that.
[VUCA IN PRACTICE]
Angela (08:30)
Let’s talk about one of those systems now. Talk us through VUCA in practice. What is it, and how has it evolved for you over your career?
Daniel (08:38)
Let’s go 30,000 feet up first, and then I’ll dive into VUCA.
Angela (08:42)
Let’s do it.
Daniel (08:43)
I mentioned quantum leadership theory, and I really encourage people to take a look at it. It’s brilliant in how it pulls chaos theory and systems theory together around leadership.
When we think about complex adaptive systems, chaos theory, and quantum leadership, there are two laws of quantum physics that really stand out to me — ones I’ve held on to throughout my leadership journey, and that I’d encourage any leader to hold on to. One is that chaos must be present in order for a system or systems to evolve. So I want you to think about that for a second. We react to chaos. We say, stop it, get it out, it can’t be here. But the reality is we need it. We need it to learn. We need it to understand how it’s impacting all the other systems. So it’s important. Our job as leaders is to recognize the chaos and understand how to shape the chaos, not to remove the chaos.
Angela (09:50)
And I would agree. Remember, Kandice, several people in a row used COVID — the chaos around COVID — as a launch point. They say COVID was the best thing that happened to their org. So it’s your same thought process: you must have chaos in order to create the system’s evolution. I love that.
Daniel (10:11)
That’s right. And this is based off quantum physics, right? That’s the cool part. The thing I like about quantum physics is there’s an absolute. It’s a math equation.
Angela (10:22)
We love that.
Daniel (10:22)
It’s really cool to think about it that way. There are 10 or 12 of these laws — I don’t remember all of them — but these two in particular. The second is that you can never have enough information to make the perfect decision. And this one is so important.
Let me give a practical example. We’re all here talking about chaos right now, and say we decide we’ve solved the chaos problem. We’ve identified all possible variables.
Kandice (10:56)
We do it every day.
Daniel (10:58)
Right? What we don’t know is that there are three other people across the ocean having the same conversation, saying they’ve solved the chaos dilemma too. They’re going to put things in motion that they believe are the right things, and we’re going to put things in motion. Eventually, those systems will interact with each other, and we don’t know what’s going to happen when they do.
You can apply that in healthcare very easily: two committees that don’t know about each other are working on the same problem —
Angela (11:39)
All the time.
Daniel (11:39)
— and they’re trying to make decisions that impact that problem. So in some way, it gives you as a leader freedom. Now, you have to assess the risk within that freedom. When something is touching a patient, of course, we need to assess that risk. But when we’re up in leadership thinking about redesigning systems and operating models, you can take more risks. You can learn, adjust, adapt, evolve. You can study that chaos.
So that’s the circle I want to create as I jump into VUCA. People might say, what the heck is VUCA? That sounds weird. It’s really simple, and that’s the reason I’ve gravitated toward it. There’s the VUCA environment we operate in, and then there’s the VUCA you can apply as a leader within that environment.
VUCA stands for volatility, uncertainty, complexity, and ambiguity. Angela and Kandice, you do podcasts all the time. Do people talk about volatility, uncertainty, complexity, and ambiguity?
Angela (13:04)
Every day.
Kandice (13:04)
When we ask them what they’re afraid of — all of these things. These are the things that keep me up at night.
Daniel (13:10)
Right. They keep us all up at night. And let’s be honest, whether it’s work or our personal lives, that is the environment we live in, and in healthcare we work in this type of environment. So the question is, as a leader, what can you do? I’ve come to subscribe to the idea that you can just do VUCA in VUCA. Keep it simple, guys.
Angela (13:32)
VUCA in VUCA. Got it.
Daniel (13:34)
It’s almost like a dance.
Kandice (13:34)
I could do that.
Daniel (13:38)
Let’s go through each one.
The V stands for vision. In an environment with volatility, uncertainty, complexity, and ambiguity, a leader’s role is to constantly reinforce the vision, or the direction you’re going. Alignment is critical. I like to keep it simple and create a visual, so here’s mine: we all need to be on the Flintstones bus, and our feet need to be going the same direction. We can’t have some people going right and some going back. Everybody needs to be going forward.
My leaders and the people I work with will tell you I do this in meetings constantly. I’ll say, let’s take a pause. Are we all moving in the same direction? Where are we going? Because of the uncertainty and complexity, that’s really important. Just like Google Maps, we might get notified that there’s a wreck up ahead, and we can take a detour. That’s okay — and we’ll get to the last part of VUCA that explains that concept. So that’s V: vision, constantly reinforcing direction.
U is understanding. To combat uncertainty, you need to generate understanding. Understanding can be who’s responsible, what our timelines are, what work we’re actually working on. We do understanding in healthcare all the time. We do root cause analysis to understand what’s causing the system to operate the way it is and to identify system problems. So we need tools and resources to generate that understanding — fishbone diagrams, cause and effect, all sorts of tools. And leaders should know them.
C: how do you combat complexity? You create clarity. The big one I’ve seen and experienced around clarity is who’s responsible, who’s accountable, who is the decision maker, who is not the decision maker —
Kandice (15:59)
That one.
Daniel (16:00)
— and who is supposed to be a consultant but thinks they’re a decision maker. So clarity is really important. Tools help you do that for projects, for work, for structures. RACI is one that comes to mind: responsible, accountable, consulted, and who just needs to be informed. There are other decision-making tools out there as well. But as a leader in this type of environment, you have to constantly create that clarity. It’s critical, so your team knows who to go to — or what committee to go to, or whatever the case might be.
And the final one, maybe the most important, is agility. We are not living in an environment — and we never will again — where there is stability. So there are no final decisions. That’s impossible. Just like you can’t make a perfect decision, you can’t make a final decision. And if you think about what I said earlier, chaos allows and helps a system evolve. We should expect, when we make decisions, to always be in the cycle of studying the impact of that decision and adjusting. Always. It’s never final, because that system is always evolving.
That’s the simplicity of the model I use to navigate the volatility, uncertainty, complexity, and ambiguity of the environments we’re in.
The final thing I’d say — and I know we all feel this — is that the speed of the VUCA environment feels like it has increased exponentially. I’ve put a lot of personal reflection into whether COVID was the catalyst. I think there are lots of variables. Whether it’s government structures and decision makers that are disrupting, companies disrupting healthcare, or AI — my gosh, AI disrupting healthcare. Suddenly every company is an AI company.
Kandice (18:28)
Exactly.
Daniel (18:29)
So there are these variables causing this speed. I think we all have to step back, take a breath, and again reinforce the vision and direction, make sure we’re generating understanding, make sure we’re creating clarity, and be the most elastic rubber band we can be.
[EVERY GENERATION’S CRISIS]
Angela (18:52)
I was sitting with Blair Childs, who we’ve had on the podcast as well. He’s such a wealth of information. He sits in Washington, D.C., and has been part of making healthcare policy under five different presidents. Think of all the things he’s seen. He’s kind of seen it all, and he said, “Angela, there is not one decade of healthcare that hasn’t thought it was in the biggest crisis of healthcare.”
Daniel (19:29)
That’s true.
Angela (19:32)
So it’s funny that you say this. It does feel like it’s moving faster to us. But when you look back, every previous generation also felt that, especially in healthcare. Listening to him say that, I thought, you’re right. We are literally repeating generations of chaos in the health system. It’s never been in a stable state.
Daniel (19:54)
Angela, as you’re saying that, I have a thought, and I’ll offer it not for us to discuss now, but for us all to reflect on later. I agree — whether it was the implementation of DRGs, which I’m sure felt like, what’s going on? Fast forward all the way to the Affordable Care Act —
Angela (20:18)
Oh my gosh, yeah.
Daniel (20:20)
— population health —
Angela (20:22)
Value-based care. What is this? We want fee-for-service.
Daniel (20:23)
Right, what’s going on?
Kandice (20:26)
I mean, paper to electronic charting. That changed the entire landscape.
Daniel (20:35)
Huge. I wonder about the variable within all of that — hear me on this one, I’m just saying it out loud. While all of that has happened, even outside of healthcare — the internet, all these things — what has happened to our human ability to retain information and concentrate? Our ability to concentrate has moved from like three seconds to 0.3 seconds. We watch micro videos now: scroll, scroll, scroll. So I’m just offering this up, and I’m going to reflect on it: maybe it’s not so much that the speed of the variables creating disruption has changed, as our own mental capacity to absorb it — because we’re just going left, right, left, right, go, go, go.
Angela (21:34)
I agree.
Kandice (21:34)
I think you’re speaking to access to information, which is different. When we were on paper charting, the information was what was in front of you, what you learned in school, what you remembered. We didn’t have a ton of access to information. So I think it is more chaotic, because there’s more to sift through.
That’s what makes these structures and frameworks so critical. When you’re in a sea of information and decisions, if you don’t have that scaffolding to walk you through it and keep everyone aligned and moving in the same direction — I think our ability to disperse and go in a million different directions is much higher than it has been in the past. So maybe it’s about holding everything together. It almost begs the question: how do we get anything done, make decisions, or create new ideas when it’s this chaotic?
[THE FLOAT TEAM: DESIGNING FOR ADAPTABILITY]
Kandice (22:30)
Can you speak to that? You’ve put together this very innovative team. It’s been covered nationally, and it’s expanding to the Lehigh Valley. This is a huge idea — in an environment like this, how do you even put it into practice?
Daniel (22:58)
Kandice, that’s a great example of everything we’re talking about. I get calls and emails all the time — hey, talk to us about this. When we start talking, I quickly reframe their mental model, because — nothing against the nurses and nurse leaders out there trying to solve problems — many times they’re trying to solve a staffing problem. Staffing is the outcome they see. The shift in mental model is: no, it’s a systems challenge that we need to think about together.
That’s the approach we took. Is this system we’d introduce going to have the outcome we expect? And how will it interact with the other systems already established across our health system and our regions? We had to go deep on that. You’ve got regional staffing offices. You’ve got a scheduling and staffing platform that may or may not be configured the same across hospitals. You’ve got policies and procedures, which are structural systems — people don’t think of it that way, but a policy, a process, a standard operating procedure is a structural system. Those can differ across all the ecosystems within our health system. So we had to look at all of the systems.
We also had to be okay with not figuring out everything — we weren’t going to know everything we needed to know before jumping in to develop this system and integrate it into the larger system.
What we observed was workforce variability across all our hospitals. We had staffing instability and volatility. One day you have too many staff, the next day you don’t have enough.
Angela (25:37)
It’s not enough.
Daniel (25:39)
And listen, this team isn’t fixing that problem. But as we started digging in, we thought the team might be a system that supports the larger ecosystems. We said, put it in the parking lot: we need to standardize the configuration of how we offer shifts so staff can self-schedule, and then balance them. We need standard operating procedures that can’t differ across our ecosystems.
Our ecosystems vary significantly in size. We have 900-bed academic hospitals in a metropolitan area, community hospitals in a metropolitan area, and now, in Lehigh Valley — the new region we’ve merged with — 10-bed micro hospitals. So we needed to develop a system flexible enough to meet all those different needs and variables. Flexibility was really important.
That’s the hot term these days — create a flexible workforce. On my to-do list is a concept analysis on nurse flexibility, because I think we all define it differently. So our core question was: how do we build adaptability directly into the system so that we can react, as proactively as possible, to the disruptions we see every day — whether it’s census fluctuations or literal emergencies? We unfortunately had a hospital catch on fire and a hospital flood, all in 12 months.
Kandice (27:26)
Gosh.
Daniel (27:27)
And I will tell you, the team allowed us to respond to those emergencies very quickly, in a way we would not have been able to if we didn’t have that system.
The design process wasn’t top-down. We brought everyone together to co-design in a thoughtful way — to understand their own systems and figure out how to connect them. We involved frontline nurses, operational leaders, nurse leaders, the regions. It’s not easy work, but you don’t co-design by yourself. That’s what’s going on with all this AI right now. Nothing against smart people, but you’ve got a lot of IT people designing AI based on what they think, and then they meet with us and we say, well, you didn’t think about this, that, and this. You have to pull it together and design together.
Then we built it. I use a philosophy: strategy, structure, process, people. You’ll notice I have lots of simple little frameworks.
Angela (28:31)
We like it. You’re speaking our language.
Daniel (28:34)
What’s the strategy? What structure supports it? What processes support the structure? And what people fit into those processes and that structure? Simple process to go through.
We had to think about things like compensation. We wanted a system that incentivizes people to come work for us — they might work at 17 different hospitals in one month. That’s extraordinary, so we should pay them like it’s extraordinary. I’ll be bold and say we had to put our money where our mouth was. But we had to be thoughtful, because we didn’t want to create too much inequity across the different systems.
We had to think about the deployment model. It’s not simple — it’s very sophisticated, with different tiers. Some nurses float only within one region, some across two regions, some across three. We recently launched the Lehigh Valley region and already have 70 nurses hired since January. Nurses want to do this.
Kandice (29:51)
Wow.
Daniel (29:52)
They love it. And here’s an interesting thing I’ve learned. The biggest lesson wasn’t whether our team could solve a staffing problem. The biggest lesson was who owns what part of the process, and when.
Kandice (30:09)
Yes. Yes.
Angela (30:11)
Ownership.
Kandice (30:13)
Ownership. We talk about this so much — who gets to make the decision. It’s a part of healthcare we talk about constantly.
Daniel (30:24)
For the audience — that wasn’t planted.
Angela (30:28)
Cue the clapping in the background.
[RED IS GOOD]
Angela (30:30)
We have so many more amazing concepts to get through, so I’m going to keep us moving. One thing you said in our prep session that I loved: red is good. Talk about that — and then we want to get into your leadership. Typically, people feel like red is bad.
Daniel (30:55)
Yes. Okay — you’ll notice I do this: 30,000 feet, then we’ll land the plane. At Jefferson, which I love, I was introduced to a concept that was new learning for me — and back to leadership, you should always be learning and evolving yourself, just as a system should be evolving. We’ve moved from the term “change management” to “change realization.” Managing change versus realizing change. You might think that’s a play on words, but it’s important. You’re not just managing what’s happening — you’re realizing it and taking actions to help realize it.
Within that framework, we have the concept: red is good. If you go back to one of the first things I said — chaos must be present in order for a system or systems to evolve — well, what is chaos? It’s red. And what do we do with red, with chaos, to evolve?
Angela (32:00)
It’s the test. It’s the test of the system.
Daniel (32:07)
We’re learning. We’re just learning. So red isn’t about failure. Red is about information. What is that information telling you, and what can you do with it? To not just manage change but realize change, you have to identify the chaos present in your system. Sometimes there’s nothing you can do about it; sometimes there are things you can do to shape it. That’s the goal of change realization. That’s why red is good — and it takes having the right culture, where you can be curious and invite inquiry around what the red is and what’s causing it.
Here’s what I find interesting. If it’s about safety and quality, we’re all about the red. We RCA it to the end of the world.
Angela (33:07)
To death.
Daniel (33:08)
We get to the core of the earth. But when it’s operational systems, when it’s finance, we don’t funnel it down the same way. We don’t five-whys those. And I ask, why? Why don’t we do that? Why is it bad? Clearly we need green in the checkbook at the end of the month, not red. But if you have red — I don’t know about you all, but I’ll tell you what I want to do if I have red at the end of the month. I want to know why. Did I go out to eat too many times? What behaviors do I need to change? I don’t punish myself for it. I ask myself what behavior needs to change.
At most organizations, red is seen as failure, and leaders don’t want to admit red — although if you’re listening to anything we’re saying, it’s not them. Ninety-five percent of the time, it’s not them, it’s the system. So how do we learn to use red, not be nervous about it, highlight it, and get it to yellow and green? It’s no different than the check engine light on your car. You can keep driving with the check engine light on, until finally it doesn’t start. I bet you pay way more to fix it when it won’t start than if you’d gotten it checked the moment you saw the light.
Angela (34:46)
That’s right.
Kandice (34:47)
It requires a specific kind of culture from the leadership team — that this is okay, that we’re looking for those things. And that philosophy — it’s the process, not the people — is so hard to instill. People come to work to do a good job, especially in healthcare. Every single one of those people shows up every day and does their very best in the dysfunctional systems we’ve created. So a leader who can say, “No, I see the systems — let’s address them so I can support you in doing what you come here to do every day” — that’s a unique leadership style, and it’s the type of leadership we need in healthcare. The reds are there whether we choose to look at them or not. It takes a specific kind of leadership — structure, planning, and a framework — to get all these people not only to see it, but to act on it and create systems that actually serve our patients and our staff in a chaotic environment.
Daniel (35:55)
Absolutely. And Kandice, let’s tie this together real quick. If you’re hiding the red, or not doing anything with it, or not talking about it, how in the world, in this VUCA environment, can you create understanding? It’s impossible.
Angela (36:15)
You cannot, because you’re doing it off of —
Daniel (36:19)
Assumptions.
Angela (36:20)
— assumptions, or even inaccuracies that are being encouraged —
Daniel (36:27)
Fake realities.
Angela (36:29)
Fake realities that people are accepting. I remember, years and years ago, the culture of safety — was it Johns Hopkins that put that out? That’s right, zero harm.
Daniel (36:46)
Yeah, zero harm.
Angela (36:50)
Even back then, it was such an interesting concept. When I left nursing and went into AI for the very first time, we started predicting all these different outcomes. The hospital said, “Well, we don’t have a problem with those outcomes.” And we said, wait, what? So we actually had to go measure. It was because they didn’t measure any of it — because they didn’t want to know. It’s not that you don’t have a problem, because patients are still experiencing it. It’s that you wanted to ignore it and didn’t want to surface it.
So I love that you say red is good, red is data, red is something we can change. If we don’t know the red, we’re just allowing the problem to keep occurring over and over again, and we can’t admit to ourselves the reason behind it. That’s so amazing.
Daniel (37:42)
Absolutely. I know you want to move on, but I’ve got an important “and,” Angela.
Angela (37:49)
Do it.
Daniel (37:51)
It’s like that check engine light analogy. The chaos in the system will come to a breaking point if you do not address it. The question is, what is that breaking point? In many instances, in healthcare or out of it, the breaking point is the people.
Angela (38:10)
It is. We’re there.
Daniel (38:11)
So the call to action is: even if you’re nervous or scared as a leader, do it for the people. Do it for your people. Do it for the community and the people you’re serving. Because when we decide not to do anything, or turn our heads the other way and don’t appreciate the red and get curious about it, what happens? People get harmed. People get hurt. Or people leave. Nurses leave, doctors leave, techs leave — and not just the organization. They leave healthcare. And they have lots of options to leave healthcare.
Angela (38:56)
I get a call a week from a nurse saying, get me out of this hospital. That’s sad to me. Every time I take that call, I think, what are we doing to our people that there’s a mass exodus? But I agree.
[LEADERSHIP PHILOSOPHY]
Angela (39:10)
First of all — amazing leadership style and structure. From the very first moment we talked to you about this, Kandice and I were very impressed. But talk to us about you and your leadership style. You’ve talked a lot about it, but what does it boil down to? What do you feel your job is?
Daniel (39:37)
I was just having this conversation two hours ago with a new nurse leader who’s trying to progress in their leadership. My job isn’t to have all the answers. My job is to help create the environment and the conditions to get the best answers possible, to make the decisions we can, so we can continue to evolve our system to a better place and shape the chaos as best we can.
And I’ve got to tell you, some days I feel like a failure at that, because it’s hard. What we’re talking about is conceptual. It’s not practically easy to lead and facilitate meetings and try to pull the red out of people. But you’ve got to remain curious, and you’ve got to remain courageous as a leader. If you can do those two things, within some structure and framework, I think you’ll get a long way.
I don’t think I got to this place by accident — I say that humbly. I tell my team all the time: I’m humbled to have you on my team, because you are smarter than me. My job is to connect and arrange — get the right people to the right discussions, focused on the right things. Every now and then, when it’s hard for the group to make a decision, I say, give me the risks, give me the pros and cons —
Angela (41:16)
And I’ll make it.
Daniel (41:18)
— and we talked about ownership: this is a place where I can own it, or I can get it to the right group and have them own the decision. And owning the decision doesn’t mean that group isn’t still responsible for the processes. That reinforcement is so important. I think we always need to be asking: how can we shape the system to be just a little bit better today?
Angela (41:53)
One percent better a day.
Daniel (41:54)
It’s the goal — like zero harm. I still remember the Dennis Quaid video; I can pull it up in my head. We won’t call out the health system. His baby was administered the wrong medication, and he became an advocate for this zero harm idea. I think that’s a lofty goal in healthcare — there are so many variables, and it’s so complex. But let’s take that lofty goal and ask: what step can we take? What’s the next step? And then what’s the next step after that?
[CLOSING QUESTION: THE MOST IMPORTANT SKILL FOR THE NEXT DECADE]
Angela (42:31)
Absolutely. This was amazing — thank you so much for spending this time with us. Our final question, which we ask everyone who comes on the show: what do you feel is the most important skill for the next decade? If you’re coaching someone young, just starting their career, what’s the most important skill they can work on to be successful?
Daniel (42:57)
I’ve already alluded to this, Angela: stay curious, and make sure you’re courageous. And I want to tie it to another quote — you’ve probably realized I’m a quote guy.
Angela (43:11)
We love it.
Daniel (43:12)
I’ll give you two quotes to wrap us up. The first I heard from Dr. Don Berwick at the International Forum on Quality and Safety many, many years ago, where I had the pleasure of presenting a poster as a nurse manager. He gave a keynote — you can look it up on YouTube, it’s phenomenal — and he said, “Silence is the enemy of progress.”
Angela (43:51)
Truth.
Daniel (43:52)
All throughout human history, silence has been the enemy of progress, not just in healthcare. Leaders — whether it’s Martin Luther King Jr. or others — remained curious and courageous. That’s the call we have as leaders.
And the final one. You’ve heard me say multiple times — this has been a huge lesson for me as a leader — I approach leadership like the President of the United States. It’s my job to build the best cabinet, one that is smarter than me and can make decisions. Regardless of where you sit on the political spectrum, every president builds a cabinet of people smarter than them, and relies on the information and expertise they provide to run all the different departments. That’s something I’ve learned, and it gets to a quote I just love: “The greatness of a man’s power is in the measure of his surrender.”
Angela (45:08)
Mic drop moment.
Kandice (45:09)
And scene. Thank you so much, Daniel. This has been amazing. You’re doing such fantastic work and being such an innovative, structure-focused leader. I think that’s how innovation occurs, like you said — we can’t have flexibility or creativity without structure, and the curiosity and commitment of everybody involved. Thank you so much for joining us today.
And thank you, audience, for joining us on Success in Chaos. Please be sure to like, follow, and share today’s episode on Spotify, Apple Podcasts, YouTube, or wherever you get your podcasts. And a special thank you to the Inflo Health team for their production support.
