Welcome to the Becker's Healthcare Podcast.
I'm Elizabeth Gregersen, a reporter here at Becker's,
and I'm thrilled today to interview doctor Hal
Skopicki,
chief of cardiology
at Stony Brook Medicine and co director of
the Stony Brook Heart Institute on podcast today.
Doctor Skopicki, thank you so much for joining
me. I'm grateful to share your insights with
our audience.
It's a real pleasure to be invited, especially
on this platform.
Absolutely. But before I dive into all my
questions,
could I ask you to introduce yourself and
tell our audience a bit about your organization?
So,
I'm a, the chief of cardiology here at
Stone and Brook and the co director of
the Heart Institute.
The Heart Institute also has expanded into include
vascular surgery
so that we're a full service line across
the board.
Stony Brook is a academic
large medical center in Suffolk County, New York,
and we deliver tertiary level care across multiple
disciplines,
in order to be able to serve our
patients
at the community level, and at an advanced
tertiary level.
In addition, we fulfill the full academic mission
of,
teaching residents,
fellows,
nursing students,
and,
also,
the research mission
of providing state of the art tools,
medicines,
and pathways
to try and push the field ahead.
Great. Thank you so much.
So you mentioned that Stony Brook has positioned
the Heart Institute as a coordinated
multidisciplinary
entity rather than, you know, a collection of
cardiology services.
If you could share with our audience
from that leadership and operational
standpoint,
what makes that institute model work in practice?
So,
this is one of those revelations
where,
the siloed approach of the past
has kinda given way to the concept that,
we really have to be putting the patient
first. And then on top of that, we
have to be teaching and we have to
be investigating.
So one of the advantages that Stony Brook
has is that we now have a single
operating system.
We operate as one heart institute,
bringing together, as I mentioned, cardiology, CT surgery
and cardiovascular
surgery.
So at the leadership level,
we have a single scorecard
rather than a slew of service lines that
are kind of reporting to themselves.
We're able to run quarterly,
year over year performance
reviews,
and we can target those areas that we
think are important.
I can go through a variety of those
examples of things,
everything from,
patient quality to patient volumes to,
how we teach,
on an individual level.
The thing that we just completed most recently
was really looking,
at something that was troubling everybody, which is,
being able to look at,
the way that we
have, seen new patients and the lab time
involved.
And by having a single dashboard,
seven outpatient sites, 25 cardiologists,
etcetera. We were able to get vital input
from all aspects of the service line,
to shorten that, lag time about 30%.
Wow. That's that's a 30%
statistic that I know our audience is always
interested to hear. So
you might have one of the Becker reporters
following up
to learn more about how you did that.
The Heart Institute has been early to adopt
and scale several advanced programs.
I'd love to hear how
you and your, co director decide
which innovations to invest in early
and kind of what mindset or strategical
balance do you employ to
be an early adopter
while also managing
financial, operational, and workforce realities?
Yeah. So that's a great question. It's one
that,
being part of the State University of New
York, at Stony Brook,
it's not that we have unlimited resources
to tap into,
for every idea that we have. And so
I guess I'd break it up into three
separate parts.
So
the first is just not going for that
shiny one off program,
but to actually try and invest in scalable
programs,
programs and platforms,
that can improve outcomes,
quality and the reliability within the,
within the process itself.
We invest earliest,
when the outcome, reliability and strategic
differentiation
all come together at the same time.
An example of that is we built an
advanced imaging capability,
using reconstruction technology.
The the benefit of it is it it
reduced
radiation up to 40%
and it improved image quality, and it improved
throughput, and it improved
the detection of people who have coronary artery
disease
so that the downstream of it all kind
of matched up with the upstream
intentions.
I think the second thing that we always
look at is just being financially disciplined
without being financially timid.
We're selective.
You know, we make a few, I guess,
what you would call signature bets,
where we can truly be excellent nationally,
rather than spreading that kind of attention over
dozens
of pilots and maybe me too type of,
investments.
And, the last part of it is something
that you just can't stress enough, and that's
to
value cooperation
and to be able to look at,
what you're trying to do as opposed to
what you're trying to compete in.
We believe that real better patient care and
better access,
staying away from the catchy phrase and,
and I guess hiring wars that some, institutions
have to face,
because it only drains
your resources.
And by partnering with a lot of different
institutions
who do things really, really well, you're able
to achieve best practices.
Perfect. I love that. And I feel like
that, you know, strategy and mindset is is
so applicable to to health care at large,
right, not just not just cardiology. So I
appreciate you sharing that.
I wanted to,
highlight as well that the Heart Institute has
achieved several standout milestones,
such as reducing, you know, the door to
balloon time to fifty three minutes
and recently becoming the first center in the
world to deliver a commercial
plazasiran.
Maybe I said it right. Maybe I didn't.
The treatment for familial
familial chlamycronemia
syndrome.
Without getting, you know, too much into the
clinical weeds of what that means and,
how that happened, I'd love to
know kind of what systems,
maybe cultural changes, priority shifts. I know you
mentioned collaboration.
What shifts have enabled
the Heart Institute at Stony Brook to have
that level of consistent
execution across, you know, very different initiatives.
Yeah. So, you are officially,
invited to join our Lipid Center because
that was an excellent, excellent,
pronunciation.
Perfect. Thank you.
You know, you brought it up as an
example. So I'll dive into the example and
then kind of generalize from there.
Yeah, we were the first lipid center in
the entire world to,
to,
administer,
the commercial dosing of, Plaza Syrian.
And it reflected
not only years of
of developing a lipid center and,
really kind of focusing on,
practitioner
insight into what is going to be next
level, But you have to have operational readiness
and,
a longitudinal
follow-up infrastructure.
You know, you have to be able to
go ahead and at each step along the
way, not just say, oh, this is something
interesting. Oh, I wish I had, but actually
have the process in place.
We run, I think, on,
what the industry calls a high reliability
playbook.
We have standard work, clear roles, you know,
that we define across domains. If somebody is
doing really well in one domain, we ask
them to teach,
you know, into the other,
other domains.
And in that way, kind of best practices
get shared.
We talk about that at every level along,
our continuum,
that it's about teaching
escalation to somebody who can help you learn.
And then, you get to be empowered,
to do the things that you want to
do. We want our local leaders to be
saying, You know what? I don't know,
and then access the information or the resources,
or be able to be,
you know, reflective and say, you know what?
We should have done that better and then
set up a goal for the next time
that we do it.
I guess, it may sound trite, but if
you kind of take away the hierarchy,
and you allow people to see you at
the same level of continual learning,
it's amazing what people are going to say
to you and do with you, that's positive
for the organization.
A simple example is that, you know,
no matter,
who they are, within,
our organization,
administrative staff, the nurses, the APPs,
the site leaders, you know, we make sure
that everybody's calling each other by their first
name.
And in that way, I think, you know,
unless you're a student,
or a resident or a fellow that needs
the hierarchy of learning,
the the rest of the crew
really needs to see you at the level
where they could be asking you honest and
sincere questions,
and not expect to be judged by it.
And I think being on a first name
basis with those people
really lends itself to doing that. I guess
the only other thing I'd add about that
is that, you know, if you're going to
do something,
you have to be able to articulate the
goals of what you're trying to do, whether
it be for a disease state,
a service line,
a process that you're trying to do, and
then be able to take that quality data
and talk about it in terms of your
goals.
And if you set it up in real
time, so the data comes out, you're able
to look at it, and then to take
it to the next level
of, brainstorming ideas, looking for best practices around
the country that might be be applicable to
your,
institution,
then you're way, way ahead of the game,
and you're not wasting time spinning your wheels.
Amazing. Thank you.
I think, you know, all the advice you
just gave blends perfectly into my last and
final question here.
If you were advising other health system leaders
who want to build an institute, you know,
specifically
a a heart institute
with real clinical integration
and national relevance,
what are one or two lessons from Stony
Brook that you would share with them?
Well, I I think the first thing that
comes to mind is the fact that
you have to understand that it really does
come down to people. Mhmm. And that, if
you start off with the concept of the
people as opposed to the structure,
the structure then becomes
so much more valuable to an institution.
And when you have those people,
either at the leadership level or, you know,
at more local levels,
you then have to empower them.
Give them an operating system
and then build programs on top of it.
Look around the country for best practices,
and then go ahead and,
and try and,
individualize
it for your location.
It's the entire hospital that cares for people.
It's not your logo or brand that cares
for people.
I think the second thing,
is that invest in the partnerships.
Whether it's the education of your,
APPs and nurses,
or,
the the fact that your physicians
getting out and being able to talk to
other
institutions, either at national meetings or just going
to those institutions,
allows you to elevate,
the practice of everybody
as they bring that information back to you.
And then I guess the final thing that
I would say is,
you're in charge of the full patient journey.
And when you go ahead and you take
a look at what the future has to
offer,
it's spectacular.
When you think about what AI, what machine
learning,
robotics,
cell therapy, gene therapy,
is going to do to our ability to
diagnose,
treat, extend the life, cure diseases,
this is it's a true joy looking forward.
And to be along for that ride, to
be,
the person or the institution
or,
the group
that the patients look to,
to be able to kind of extend the
quality of their life and the length of
their life.
It's a wonderful future ahead.
And, as part of an academic
it couldn't be more fun than this.
Wonderful.
I just can't appreciate or express how much
I appreciate you joining me on the podcast
today. It's been a truly informative conversation.
You know, I think the common themes of
just collaboration,
centering the person, you know, calling people by
their first name are are all such great
valuable insights for not just
our cardiology audience, but for the health care
audience in general. So,
again, I can't thank you enough for joining
me.
Truly a pleasure, and thank you for the
opportunity and look forward to listening to a
lot more podcasts in my future.
Absolutely.
And to our other podcast listeners, you can
find more podcasts from Becker's Healthcare by visiting
our podcast page at beckershospitalreview.com.
Thank you again. I hope you all have
a wonderful rest of your day.