Island Life

Leading Women: Dr. Jill Hoggard Green on Bringing the Fight to COVID-19 and More

Reading time: 6 Minutes

March 20th, 2021

photo of Dr. Jill Hoggard Green photo of Dr. Jill Hoggard Green

One of Dr. Jill Hoggard Green's earliest memories is accompanying her mother, a nurse, as she made house calls in their tiny Utah town. “Whenever anyone was disabled or sick, we went and visited them," she recalls. “If they didn't have an infectious disease, I got to go along, and she let me carry the casserole—because you always brought food."

That focus on compassionate, holistic care inspired Hoggard Green to pursue a career in nursing. It also shapes her approach to healthcare leadership as president and CEO of The Queen's Health Systems.

A nationally acclaimed and highly respected leader with a Ph.D. in Healthcare Leadership and Quality, Hoggard Green took the helm of Hawaii's largest private, non-profit hospital in October 2019. Three months later, the world started talking about an aggressive new coronavirus spreading in China. Three months after that, the first COVID-19 patient was diagnosed in Hawaii.

All the lessons Hoggard Green had learned from her mother, her schooling and her career to date were about to be put to the test.

Called to Service

Hoggard Green brought a wealth of experience to her new role at Queen's. She previously served as chief operating officer (COO) for Mission Health and president of Mission Hospital in Asheville, NC, and was named one of the country's top 25 COOs by Modern Healthcare in 2018. While leading Mission, the team improved patient experience from the 55th to 90th percentile, reduced overall mortality by more than 40%, doubled revenue and income while markedly expanding ambulatory services, and improved employee engagement to more than double the national benchmark. Prior to that, she served as COO of the Oregon Region of Peace Health hospital system and spent more than 15 years at Intermountain Healthcare in Salt Lake City, Utah.

Her career has included work with the oncology and bone marrow transplant units at a level I trauma facility, and at hospitals, ambulatory and home health services.

She says she gravitated to health care after taking health classes in high school. “I realized it was my calling," she recalls. “I've always been focused on how to improve health and wellbeing in yourself, your family and your community."

She was influenced by her mother, Beverly Bennett Hoggard, and her aunt, Clifta Bennett Varney, who grew up as the oldest of 13 children in the Depression, and went to nursing school on the GI Bill. “They were both wonderful nurses and very smart, resilient women," she says. “They were committed to doing the right thing, a life of service, and worked extraordinarily hard."

Hoggard Green says her nursing experience has shaped her approach to healthcare leadership, including a focus on caring for the whole individual and family, health promotion and supporting patients in managing their chronic illnesses.  Her decision making is thoughtfully based on science and data.

"I start every day thinking about our patients, their  Ľohana and our caregivers," she says. "I'm always thinking about how we can support our wonderful caregivers and ensure they have the best protocols and the resources they need."

Resetting Priorities

Hoggard Green describes her first few weeks with Queen's as “joyous," as she spent time traveling around the hospital system and getting to know its various frontline workers and healthcare teams.

When she was hired as CEO, the hospital's priorities included safety and quality control, improving regional care and bettering the health of Hawaii’s populations. Founded in 1859, the Queen’s mission is to provide quality healthcare services to Native Hawaiians and all of the people of Hawaii. Hoggard Green embraced this work.

With the arrival of COVID-19, however, the hospital had to move quickly. Focus shifted to understanding the disease and how it spreads, learning how to protect patients and staff, and caring for incoming COVID-19 patients.

But even as pandemic response became the hospital's top priority, Hoggard Green says she didn't see the crisis as an interruption of her plans. “The pandemic really called to my heart the mission of Queen's," she says. “Queen's was created by Queen Emma and King Kamehameha IV to battle pandemics because they were seeing individuals dying of infectious diseases. So this gets to the core of who we are."

The fact that COVID-19 was a previously unknown disease meant that the hospital's clinicians were still working to understand it even as they moved quickly to treat patients and control its spread.

“Every day, there was innovation. Every day there were improvements," Hoggard Green says. “Understanding public health and how infectious diseases are transmitted, I knew that we needed to work together across all our health systems. During this critical time, the support from our Board of Trustees has been overwhelming. I am also grateful to our community, our government partners, and our 8,000 caregivers and over 1,400 physicians who have come together to battle this disease."

Immediate changes included putting up tents outside the Emergency Department so patients could be tested without exposing others in the hospital. Within a week it was clear more testing was needed, so the hospital shifted to a drive-up testing model.

Coordinating the COVID-19 response effort would be no small task: Queen's operates a 575-bed acute care facility and Hawaii's only level I trauma center, employing 7,000 caregivers, technicians, administrators and staff. The system includes four hospitals on three islands, a diagnostic laboratory, a home care agency, ambulatory care facilities and more than 1,500 affiliated physicians and providers statewide.

One of the biggest challenges was delivering compassionate care during a pandemic that was not only overwhelming in its scope, but unusually cruel.

"COVID is a devastating disease," she says. "As patients came to the hospital, they were very ill. For the safety of patients and caregivers, there were regulations across the country about not having visitors. What I saw then was extraordinary compassion. Our caregivers were providing not only for patients' physical needs, but their emotional needs as well. It was humbling to watch."

Still in the Fight

As Hawaii marks the one-year anniversary of COVID-19 in the Islands, the focus of healthcare has shifted from the immediate crisis response to long-term recovery. At Queen's, in addition to caring for COVID patients and keeping up safety protocols, clinicians are stepping up the effort to vaccinate people.

While the vaccine supply is still low, Hoggard Green is optimistic it will grow in the coming months, leading to a rapid increase in vaccinations. “We are still very much in the fight with COVID," she says. “This is a virus that wants to live. It mutates and develops variants very rapidly, and it transmits very rapidly, so we can't let our guard down. We have to get people vaccinated and do everything we can to get in front of this disease."

At the same time, hospitals are reckoning with inequities in healthcare that have been laid bare by COVID. “We saw not only here but around the country that individuals that had a lack of resources or social determinants of health were much more vulnerable to this disease," she says.

As a healthcare system with a special mission to support the health of Native Hawaiians, Queen's is going to be taking a hard look at its role in countering barriers to health and redesigning systems to better meet the needs of the people it serves.

“It's very important that people have access to housing, good food and environments that are free of violence," she says. “As a healthcare system, we're going to be leaning into those issues to see what part we can play."

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