1 00:00:02,240 --> 00:00:05,040 The most important health care decisions don't happen 2 00:00:05,040 --> 00:00:05,779 in isolation. 3 00:00:06,160 --> 00:00:08,099 They happen when leaders come together. 4 00:00:08,720 --> 00:00:11,519 Becker's sixteenth annual meeting brings together more than 5 00:00:11,519 --> 00:00:12,500 3,500 6 00:00:12,559 --> 00:00:15,494 hospital and health system executives this April in 7 00:00:15,494 --> 00:00:15,994 Chicago. 8 00:00:16,535 --> 00:00:20,234 With 800 speakers from Ascension, Cleveland Clinic, CommonSpirit 9 00:00:20,375 --> 00:00:23,414 and more, the conversations get real. Leaders will 10 00:00:23,414 --> 00:00:25,994 share how their scenario planning for policy shifts, 11 00:00:26,214 --> 00:00:28,670 breaking through value based care barriers, and building 12 00:00:28,670 --> 00:00:31,470 clinical teams that translate new ideas into real 13 00:00:31,470 --> 00:00:32,289 world care. 14 00:00:32,909 --> 00:00:35,440 Join top decision makers in the room April 15 00:00:35,440 --> 00:00:37,010 13 through the sixteenth. 16 00:00:37,469 --> 00:00:41,710 For the agenda and event details, visit beckershospitalreview.com 17 00:00:41,710 --> 00:00:43,469 and click on the events tab in the 18 00:00:43,469 --> 00:00:43,905 upper right. 19 00:00:45,344 --> 00:00:47,744 This is Laura Dirda with the Becker's Healthcare 20 00:00:47,744 --> 00:00:49,824 podcast. I'm thrilled today to be joined by 21 00:00:49,824 --> 00:00:50,884 doctor Vic Kashyap, 22 00:00:51,265 --> 00:00:53,265 endowed chair of the Frederick Meyer Heart and 23 00:00:53,265 --> 00:00:55,684 Vascular Institute and vice president of cardiovascular 24 00:00:56,144 --> 00:00:58,490 health at Corwell Health. Doctor Kashyap, it's a 25 00:00:58,490 --> 00:01:00,109 pleasure to have you on the podcast today. 26 00:01:00,729 --> 00:01:02,969 Thank you so much, Laura, for including me 27 00:01:02,969 --> 00:01:05,310 in your series. Very happy to be here. 28 00:01:05,770 --> 00:01:08,329 Absolutely. Now I'm excited for our conversation because 29 00:01:08,329 --> 00:01:08,969 I know, 30 00:01:09,290 --> 00:01:10,349 you know, the cardiovascular 31 00:01:10,650 --> 00:01:12,489 care is such a dynamic space. There's so 32 00:01:12,489 --> 00:01:15,185 much happening, and you know, really interesting to 33 00:01:15,185 --> 00:01:17,585 kinda think about how it's evolving. Most people 34 00:01:17,585 --> 00:01:19,424 in their lifetimes are either touched by this 35 00:01:19,424 --> 00:01:21,344 type of care or have loved ones who 36 00:01:21,344 --> 00:01:22,784 are. And so, you know, I'm excited to 37 00:01:22,784 --> 00:01:24,725 learn more about how you're thinking about, 38 00:01:25,185 --> 00:01:26,865 things today and and what you're seeing in 39 00:01:26,865 --> 00:01:28,465 the future. But before we dive in, can 40 00:01:28,465 --> 00:01:29,579 you tell us a little bit more about 41 00:01:29,579 --> 00:01:31,200 yourself and CorVel Health? 42 00:01:31,980 --> 00:01:33,040 Yeah. Happy to. 43 00:01:33,659 --> 00:01:36,560 So I'm a vascular surgeon by training. 44 00:01:36,939 --> 00:01:39,340 I spent, the majority of my career in 45 00:01:39,340 --> 00:01:41,120 Cleveland, Ohio. I was there 46 00:01:41,454 --> 00:01:42,915 for a couple of decades. 47 00:01:43,375 --> 00:01:45,634 And then a few years ago, got contacted 48 00:01:45,775 --> 00:01:46,754 about this opportunity, 49 00:01:47,215 --> 00:01:49,634 which was to run a heart and vascular 50 00:01:49,854 --> 00:01:50,354 institute. 51 00:01:50,894 --> 00:01:53,055 And I'll say that Korbo Health and and 52 00:01:53,055 --> 00:01:55,155 this area has been evolving, 53 00:01:55,799 --> 00:01:56,299 changing 54 00:01:56,680 --> 00:01:59,259 very dramatically over the last few decades. 55 00:01:59,799 --> 00:02:01,500 So initially, Butterworth Hospital, 56 00:02:01,879 --> 00:02:04,379 was a community hospital, and then Spectrum Health, 57 00:02:04,519 --> 00:02:06,299 a system in West Michigan. 58 00:02:07,000 --> 00:02:09,525 And Spectrum Health, which I joined back in 59 00:02:09,525 --> 00:02:10,585 2022, 60 00:02:10,724 --> 00:02:12,805 merged with Beaumont Health, which is on the 61 00:02:12,805 --> 00:02:15,145 East side of the state in Metro Detroit, 62 00:02:15,284 --> 00:02:18,724 and we're now called Corwell Health. So, for 63 00:02:18,724 --> 00:02:20,724 those podcasts that you do on branding, we 64 00:02:20,724 --> 00:02:22,504 have a little branding confusion, 65 00:02:23,379 --> 00:02:24,919 since we've had some name changes. 66 00:02:25,300 --> 00:02:28,500 But we're now a 21 hospital system across 67 00:02:28,500 --> 00:02:29,959 the state of Michigan, 68 00:02:30,419 --> 00:02:32,840 and our goal really is to provide comprehensive 69 00:02:32,979 --> 00:02:35,879 care for, our patients and our communities. 70 00:02:36,955 --> 00:02:38,955 I love that. And it's simple yet, you 71 00:02:38,955 --> 00:02:41,034 know, so complex when you think about everything 72 00:02:41,034 --> 00:02:43,354 that entails providing that type of complex care 73 00:02:43,354 --> 00:02:46,474 and access to care for the broader, communities 74 00:02:46,474 --> 00:02:49,579 and populations you're serving. So I'm curious. Can 75 00:02:49,579 --> 00:02:50,860 you tell us a little bit more about 76 00:02:50,860 --> 00:02:52,859 the last year? So what was an important 77 00:02:52,859 --> 00:02:54,299 initiative that you led? What did you do, 78 00:02:54,299 --> 00:02:55,439 and what were the results? 79 00:02:55,979 --> 00:02:56,479 Yeah. 80 00:02:57,019 --> 00:02:59,680 So we've, the Franklin Meyer Heart and Vascular 81 00:02:59,739 --> 00:03:00,959 Institute has been, 82 00:03:01,955 --> 00:03:04,754 in place for over a decade now, and 83 00:03:04,754 --> 00:03:06,775 the Meyer Heart Center is a 84 00:03:07,555 --> 00:03:10,594 eight story hospital devoted to heart and vascular 85 00:03:10,594 --> 00:03:11,094 care 86 00:03:11,395 --> 00:03:13,495 that's been in place for over twenty years. 87 00:03:14,449 --> 00:03:15,349 That being said, 88 00:03:15,969 --> 00:03:18,550 like many places, I think we were still 89 00:03:18,930 --> 00:03:20,069 fairly fragmented. 90 00:03:20,849 --> 00:03:22,629 You know, silos in 91 00:03:23,250 --> 00:03:23,750 cardiology, 92 00:03:24,209 --> 00:03:24,870 in cardiac, 93 00:03:25,490 --> 00:03:28,389 in thoracic surgery, in vascular surgery, 94 00:03:29,034 --> 00:03:31,294 in wound care, in multiple areas, 95 00:03:31,995 --> 00:03:32,974 across the 96 00:03:33,514 --> 00:03:34,014 cardiovascular 97 00:03:35,115 --> 00:03:35,615 landscape. 98 00:03:36,074 --> 00:03:37,134 And I think perhaps 99 00:03:37,514 --> 00:03:39,034 not just last year, but in the last 100 00:03:39,034 --> 00:03:39,854 couple years, 101 00:03:40,555 --> 00:03:41,375 our biggest 102 00:03:42,710 --> 00:03:43,210 success 103 00:03:43,590 --> 00:03:44,730 has been really 104 00:03:45,590 --> 00:03:48,090 becoming much more collaborative, much more 105 00:03:48,389 --> 00:03:48,889 coordinated 106 00:03:49,430 --> 00:03:51,370 as a Heart and Vascular Institute. 107 00:03:51,830 --> 00:03:54,310 So what does that mean? For instance, we 108 00:03:54,310 --> 00:03:55,530 have really focused 109 00:03:56,165 --> 00:03:58,824 on ensuring the highest quality for our patients. 110 00:03:59,284 --> 00:04:01,604 Now every physician, every group wants to do 111 00:04:01,604 --> 00:04:04,085 that, but what we've done is looked at 112 00:04:04,085 --> 00:04:05,944 it at a system level. 113 00:04:06,805 --> 00:04:08,504 So we look at 114 00:04:08,849 --> 00:04:11,169 every mortality that happens in the heart and 115 00:04:11,169 --> 00:04:12,229 vascular space. 116 00:04:12,849 --> 00:04:13,669 Each group 117 00:04:14,050 --> 00:04:17,649 is tasked to really do a very careful 118 00:04:17,649 --> 00:04:18,149 analysis 119 00:04:18,930 --> 00:04:21,410 and then bring back to us any lessons 120 00:04:21,410 --> 00:04:21,910 learned, 121 00:04:23,044 --> 00:04:24,344 any gaps in care, 122 00:04:24,805 --> 00:04:27,284 and any other items that can really be 123 00:04:27,284 --> 00:04:27,784 socialized 124 00:04:28,884 --> 00:04:31,685 for our group as a whole to improve 125 00:04:31,685 --> 00:04:32,584 the care of patients. 126 00:04:33,204 --> 00:04:35,204 Well, what's happened? Over the last three to 127 00:04:35,204 --> 00:04:37,865 four years, we've dropped our raw mortality, 128 00:04:39,019 --> 00:04:39,519 significantly. 129 00:04:40,779 --> 00:04:44,620 We have improved our observed to expected mortality 130 00:04:44,620 --> 00:04:45,120 ratio, 131 00:04:46,060 --> 00:04:48,539 which was, at the one level that is 132 00:04:48,539 --> 00:04:50,079 on par or average 133 00:04:50,379 --> 00:04:51,839 down to point six seven. 134 00:04:52,834 --> 00:04:53,894 And I think that 135 00:04:54,354 --> 00:04:55,415 focus on 136 00:04:56,115 --> 00:04:56,615 improving 137 00:04:57,875 --> 00:05:00,514 individual patient care and then having the lessons 138 00:05:00,514 --> 00:05:01,014 learned, 139 00:05:02,274 --> 00:05:03,254 in one area 140 00:05:03,875 --> 00:05:06,035 be socialized to all areas across the Heart 141 00:05:06,035 --> 00:05:08,229 and Vascular Institute have really been a great 142 00:05:08,229 --> 00:05:09,209 success for us. 143 00:05:10,149 --> 00:05:11,909 And it's helpful to understand. You know? And 144 00:05:11,909 --> 00:05:14,310 it I, really appreciate you kind of talking 145 00:05:14,310 --> 00:05:16,810 through the systematic way that you approached 146 00:05:17,669 --> 00:05:19,689 trying to tackle some of these issues because, 147 00:05:20,389 --> 00:05:23,725 I think having, you know, heart issues and 148 00:05:23,725 --> 00:05:25,564 challenges are so such a big, 149 00:05:25,964 --> 00:05:28,604 issue for patients, their families. And so being 150 00:05:28,604 --> 00:05:29,345 able to, 151 00:05:30,125 --> 00:05:32,044 provide some of those back best practices and 152 00:05:32,044 --> 00:05:34,044 really figure out what makes the most sense, 153 00:05:34,285 --> 00:05:36,800 in terms of moving the needle for mortality, 154 00:05:37,500 --> 00:05:39,580 is so helpful. Can you dig a little 155 00:05:39,580 --> 00:05:41,580 bit deeper in there? How did you really, 156 00:05:42,379 --> 00:05:43,740 make a difference, or what were some of 157 00:05:43,740 --> 00:05:45,740 the things that you did and changes that 158 00:05:45,740 --> 00:05:48,060 you made in order to serve the community 159 00:05:48,060 --> 00:05:48,560 better? 160 00:05:48,955 --> 00:05:49,694 Yep. So 161 00:05:50,235 --> 00:05:52,875 I will I'll have to make sure to 162 00:05:52,875 --> 00:05:54,814 credit all of our amazing 163 00:05:55,355 --> 00:05:55,855 teams, 164 00:05:56,235 --> 00:05:56,975 our physicians, 165 00:05:57,514 --> 00:05:58,254 our surgeons, 166 00:05:58,634 --> 00:06:01,855 our other providers, including nurse practitioners 167 00:06:02,235 --> 00:06:02,895 and PAs 168 00:06:03,560 --> 00:06:05,180 that are part of the team nurses, 169 00:06:05,560 --> 00:06:07,339 they have worked diligently 170 00:06:07,720 --> 00:06:08,540 and collaboratively 171 00:06:09,400 --> 00:06:11,240 to really provide great care for a long 172 00:06:11,240 --> 00:06:12,139 period of time. 173 00:06:12,839 --> 00:06:14,939 However, we did see improvements, 174 00:06:15,879 --> 00:06:16,860 in heart surgery, 175 00:06:17,194 --> 00:06:18,014 in cardiology, 176 00:06:18,314 --> 00:06:19,454 in vascular surgery, 177 00:06:19,754 --> 00:06:21,935 in terms of thirty day mortality. 178 00:06:22,794 --> 00:06:25,675 I think this was both a refinement of 179 00:06:25,675 --> 00:06:28,574 practice and very careful selection of patients. 180 00:06:29,430 --> 00:06:31,910 We also saw an improve in our o 181 00:06:31,910 --> 00:06:32,810 to e ratio 182 00:06:33,189 --> 00:06:35,209 probably because of documentation. 183 00:06:36,069 --> 00:06:36,810 That is, 184 00:06:37,110 --> 00:06:39,189 we had very sick patients here in West 185 00:06:39,189 --> 00:06:40,810 Michigan just like many other 186 00:06:41,269 --> 00:06:44,389 urban and semi urban areas, but maybe we 187 00:06:44,389 --> 00:06:44,889 weren't 188 00:06:45,274 --> 00:06:47,995 displaying how ill they were till we did 189 00:06:47,995 --> 00:06:50,394 a better job of looking at risk factors 190 00:06:50,394 --> 00:06:53,194 and documenting them appropriately in the record. So 191 00:06:53,194 --> 00:06:54,974 I think those two things. One, 192 00:06:55,514 --> 00:06:59,055 absolute or raw mortality decreasing, but then also 193 00:06:59,329 --> 00:07:01,829 the expected mortality for a cohort of patients 194 00:07:02,129 --> 00:07:05,350 increasing because of the risk of that population 195 00:07:05,970 --> 00:07:06,790 being appropriately 196 00:07:07,250 --> 00:07:07,750 delineated 197 00:07:08,529 --> 00:07:10,870 has been the sex success here. 198 00:07:11,585 --> 00:07:12,944 That makes a lot of sense. And, you 199 00:07:12,944 --> 00:07:14,485 know, it's helpful to understand, 200 00:07:15,185 --> 00:07:17,105 all the different kind of adjustments that that 201 00:07:17,105 --> 00:07:19,745 you're making to move the needle. Now looking 202 00:07:19,745 --> 00:07:21,985 ahead for 2026, what are some of the 203 00:07:21,985 --> 00:07:24,225 big priorities and headwinds that you're most focused 204 00:07:24,225 --> 00:07:24,720 on? 205 00:07:25,519 --> 00:07:27,839 Yeah. One of the, big challenges we had 206 00:07:27,839 --> 00:07:29,459 last year is a, 207 00:07:30,240 --> 00:07:32,019 complete change in 208 00:07:32,319 --> 00:07:33,779 our anesthesia workforce. 209 00:07:35,040 --> 00:07:36,100 And this is not 210 00:07:36,894 --> 00:07:39,454 dissimilar to some of the other, systems and 211 00:07:39,454 --> 00:07:42,414 hospitals around the country. We've moved from, 212 00:07:43,134 --> 00:07:44,675 a private practice 213 00:07:45,294 --> 00:07:46,514 contracted model 214 00:07:46,894 --> 00:07:48,194 to an employed model. 215 00:07:48,894 --> 00:07:50,995 And that was a big change for 216 00:07:52,020 --> 00:07:52,759 the system, 217 00:07:53,379 --> 00:07:55,460 for the hospital, and quite frankly, for each 218 00:07:55,460 --> 00:07:55,960 individual 219 00:07:56,740 --> 00:07:58,279 physician, especially the surgeons, 220 00:07:59,060 --> 00:08:00,920 that rely on great anesthetic 221 00:08:01,379 --> 00:08:03,699 care for taking care of their patients. So 222 00:08:03,699 --> 00:08:05,240 we're in the midst of this transition, 223 00:08:06,375 --> 00:08:07,754 going to an employed model, 224 00:08:08,454 --> 00:08:10,394 that has meant a lot of recruiting 225 00:08:10,935 --> 00:08:12,154 of great anesthesiologists. 226 00:08:13,654 --> 00:08:15,095 And oh, by the way, let me put 227 00:08:15,095 --> 00:08:16,774 a plug. If somebody wants to come join 228 00:08:16,774 --> 00:08:19,095 us in CORWAIL. I hope in Grand Rapids, 229 00:08:19,095 --> 00:08:19,914 we are open 230 00:08:20,699 --> 00:08:22,360 to we have open arms, 231 00:08:22,740 --> 00:08:24,439 but that has been, as you can imagine, 232 00:08:24,740 --> 00:08:26,120 a lot of change management. 233 00:08:26,980 --> 00:08:29,399 Different people in the operating room, different 234 00:08:30,259 --> 00:08:31,560 processes, perhaps, 235 00:08:32,259 --> 00:08:33,480 in some areas, 236 00:08:34,214 --> 00:08:37,574 people coming from different cultures, coming to to 237 00:08:37,574 --> 00:08:40,375 this culture, this medical culture here. So all 238 00:08:40,375 --> 00:08:42,134 of that change, I think, has been very 239 00:08:42,134 --> 00:08:42,634 disruptive, 240 00:08:43,095 --> 00:08:43,595 and 241 00:08:44,134 --> 00:08:46,074 getting to a point where we're 242 00:08:47,039 --> 00:08:50,000 almost complete or maximally employed in that department 243 00:08:50,000 --> 00:08:52,240 of anesthesia is gonna be a hallmark for 244 00:08:52,240 --> 00:08:55,460 us. We hope to accomplish that in 2026. 245 00:08:55,919 --> 00:08:58,960 I think that really stabilizes our surgical and 246 00:08:58,960 --> 00:09:01,379 procedural areas to a great degree. 247 00:09:02,725 --> 00:09:04,324 That's it makes a lot of sense. You 248 00:09:04,324 --> 00:09:06,644 know, that is such a huge change, especially 249 00:09:06,644 --> 00:09:08,725 with anesthesia. I know today, you know, across 250 00:09:08,725 --> 00:09:10,485 the board is something that is top of 251 00:09:10,485 --> 00:09:12,884 mind for so many clinical teams, and trying 252 00:09:12,884 --> 00:09:14,404 to figure out the right model that makes 253 00:09:14,404 --> 00:09:16,664 sense in each community is no easy task. 254 00:09:16,839 --> 00:09:18,360 And so when you're going through, you know, 255 00:09:18,360 --> 00:09:20,919 some big changes like this, especially when it's 256 00:09:20,919 --> 00:09:22,299 operational things happening, 257 00:09:22,679 --> 00:09:24,919 in the operating room, but then too, you 258 00:09:24,919 --> 00:09:27,740 know, wanting to make sure that clinicians have, 259 00:09:28,360 --> 00:09:29,085 faith and 260 00:09:29,965 --> 00:09:32,125 and really trust their colleagues to deliver the 261 00:09:32,125 --> 00:09:33,725 best care possible. But how do you go 262 00:09:33,725 --> 00:09:36,205 about this change management and making sure that, 263 00:09:36,445 --> 00:09:38,764 you know, everybody across the board is comfortable 264 00:09:38,764 --> 00:09:40,764 with how you're moving forward and, you know, 265 00:09:40,764 --> 00:09:42,285 ready to do whatever it takes in order 266 00:09:42,285 --> 00:09:44,304 to keep that great quality care going? 267 00:09:45,269 --> 00:09:47,750 Yeah. Well, I think the first element is 268 00:09:47,750 --> 00:09:48,250 communication 269 00:09:48,789 --> 00:09:49,529 and maybe 270 00:09:50,309 --> 00:09:52,889 communicate, communicate, communicate over communication. 271 00:09:53,429 --> 00:09:55,289 And we do this in in a multimodal 272 00:09:56,230 --> 00:09:58,169 way. We have town halls, 273 00:09:59,254 --> 00:10:01,174 where we have all the members of the 274 00:10:01,174 --> 00:10:03,575 Hart and Vascular Institute, which are now over 275 00:10:03,575 --> 00:10:04,475 a thousand people, 276 00:10:05,414 --> 00:10:06,154 dial in, 277 00:10:06,615 --> 00:10:08,554 for a virtual town hall. 278 00:10:08,934 --> 00:10:09,434 We, 279 00:10:10,225 --> 00:10:10,725 have 280 00:10:11,110 --> 00:10:13,269 in person grand rounds once a month where 281 00:10:13,269 --> 00:10:14,330 we hit some of these 282 00:10:14,870 --> 00:10:16,730 topics. We have a monthly newsletter, 283 00:10:17,750 --> 00:10:18,649 and I meet, 284 00:10:19,029 --> 00:10:19,529 periodically 285 00:10:20,070 --> 00:10:21,129 with different teams 286 00:10:21,590 --> 00:10:23,990 in different spaces, whether it be the vascular 287 00:10:23,990 --> 00:10:26,684 surgeons or the thoracic surgeons or the electrophysiologist 288 00:10:27,544 --> 00:10:28,284 or other, 289 00:10:29,144 --> 00:10:31,804 proceduralists that get affected by this change. 290 00:10:32,664 --> 00:10:35,164 So one is to communicate what's happening. 291 00:10:35,544 --> 00:10:37,704 Two is to be really brilliant at the 292 00:10:37,704 --> 00:10:40,879 tactical changes that are occurring on a daily 293 00:10:40,879 --> 00:10:42,259 basis, whether it be schedules, 294 00:10:42,639 --> 00:10:45,519 whether it's using a certain number of locums 295 00:10:45,519 --> 00:10:47,440 providers to fill in the gap till we 296 00:10:47,440 --> 00:10:48,980 get to a fully employed model, 297 00:10:49,759 --> 00:10:51,679 and other things. And then I think the 298 00:10:51,679 --> 00:10:54,284 other the the other part about this, Laura, 299 00:10:54,284 --> 00:10:55,985 is also to really 300 00:10:56,365 --> 00:10:59,804 have folk have people focus on the long 301 00:10:59,804 --> 00:11:02,044 term. What is gonna be the long term 302 00:11:02,044 --> 00:11:03,664 effect of this? Well, 303 00:11:04,125 --> 00:11:05,644 it's gonna be that we're gonna have a 304 00:11:05,644 --> 00:11:07,985 department of anesthesia that is as aligned 305 00:11:08,764 --> 00:11:09,264 with 306 00:11:10,139 --> 00:11:12,220 the different strategies that we have for the 307 00:11:12,220 --> 00:11:15,199 Heart and Vascular Institute, including quality, including 308 00:11:15,659 --> 00:11:16,159 research, 309 00:11:16,539 --> 00:11:17,039 education, 310 00:11:18,379 --> 00:11:20,240 strategic growth, etcetera. 311 00:11:20,699 --> 00:11:23,100 And that's gonna be a very positive state 312 00:11:23,100 --> 00:11:24,779 for us once we were able to achieve 313 00:11:24,779 --> 00:11:25,279 this. 314 00:11:26,195 --> 00:11:27,955 I love that. I think being able to 315 00:11:27,955 --> 00:11:31,415 have that type of, communication, clarity, and relationship 316 00:11:31,475 --> 00:11:33,955 with the team that they understand exactly what's 317 00:11:33,955 --> 00:11:36,035 going to happen and why things are happening, 318 00:11:36,035 --> 00:11:38,035 and then really get on board to make 319 00:11:38,035 --> 00:11:39,654 that change makes a big difference. 320 00:11:40,120 --> 00:11:41,800 What do you think, the hardest thing you 321 00:11:41,960 --> 00:11:43,240 that you'll have to do in the coming 322 00:11:43,240 --> 00:11:43,899 year will 323 00:11:44,279 --> 00:11:45,960 be? Well, that may be the hardest thing, 324 00:11:45,960 --> 00:11:47,320 but let me tell you about a couple 325 00:11:47,320 --> 00:11:48,700 of other things that I think, 326 00:11:49,559 --> 00:11:52,379 that are happening that, are are big changes. 327 00:11:52,759 --> 00:11:54,759 So we've been a heart and vascular institute, 328 00:11:54,759 --> 00:11:55,420 but recently, 329 00:11:56,495 --> 00:11:57,715 we also incorporated 330 00:11:58,174 --> 00:11:59,554 the pulmonary division 331 00:12:00,174 --> 00:12:00,674 into, 332 00:12:01,054 --> 00:12:01,554 our, 333 00:12:02,174 --> 00:12:02,914 our area. 334 00:12:03,455 --> 00:12:05,455 So now, actually, we're in the midst of 335 00:12:05,455 --> 00:12:07,294 a name change again, but it's not for 336 00:12:07,294 --> 00:12:10,254 the overall organization. It's for our department as 337 00:12:10,254 --> 00:12:11,315 we go to the 338 00:12:11,720 --> 00:12:13,580 heart, lung, and vascular, 339 00:12:14,279 --> 00:12:14,779 department. 340 00:12:15,960 --> 00:12:18,600 And that's important for, many reasons. This was 341 00:12:18,600 --> 00:12:19,340 an organizational 342 00:12:19,879 --> 00:12:22,540 change that, that we did not ask for. 343 00:12:22,840 --> 00:12:24,940 This happened, because of some changes 344 00:12:25,504 --> 00:12:27,365 in the overall structure of the organization. 345 00:12:27,745 --> 00:12:30,725 We really welcome this as a great opportunity 346 00:12:31,424 --> 00:12:32,404 for the pulmonologists 347 00:12:32,784 --> 00:12:35,024 who already collaborate, by the way, with many 348 00:12:35,024 --> 00:12:36,884 of our thoracic surgeons and others 349 00:12:37,504 --> 00:12:38,004 to 350 00:12:38,929 --> 00:12:40,950 really even enhance that relationship, 351 00:12:41,490 --> 00:12:45,029 especially for lung cancer treatment, for lung transplant, 352 00:12:45,409 --> 00:12:46,389 and other areas. 353 00:12:47,409 --> 00:12:50,070 We've had a lot of folks in overlapping 354 00:12:50,209 --> 00:12:50,709 areas, 355 00:12:51,409 --> 00:12:52,389 related to 356 00:12:53,215 --> 00:12:55,634 both pulmonary and cardiac issues, 357 00:12:56,095 --> 00:12:58,034 let's say, in the areas of syncope, 358 00:12:58,335 --> 00:12:59,875 in the areas of 359 00:13:00,575 --> 00:13:03,794 of, shortness of breath, etcetera. Now these groups 360 00:13:04,095 --> 00:13:05,794 that are often are evaluating 361 00:13:06,095 --> 00:13:07,475 similar types of patients 362 00:13:07,940 --> 00:13:10,919 are all under one roof, and they can 363 00:13:10,980 --> 00:13:11,480 hopefully 364 00:13:12,179 --> 00:13:14,740 elevate the care that they're giving, elevate their 365 00:13:14,740 --> 00:13:17,139 algorithms to an even greater level. And I 366 00:13:17,139 --> 00:13:19,139 think the last thing that's this is really 367 00:13:19,139 --> 00:13:19,959 gonna be 368 00:13:20,259 --> 00:13:20,759 impactful 369 00:13:21,139 --> 00:13:22,120 is our whole 370 00:13:23,024 --> 00:13:25,125 research infrastructure where we have 371 00:13:25,504 --> 00:13:27,985 tremendous number of folks that are interested in 372 00:13:27,985 --> 00:13:31,584 research. We've started about over 60 trials now 373 00:13:31,824 --> 00:13:34,784 I'm sorry, over 70 trials in the last 374 00:13:34,784 --> 00:13:36,245 five years, clinical trials. 375 00:13:36,799 --> 00:13:39,360 And this allows groups that previously had been 376 00:13:39,360 --> 00:13:39,860 separate 377 00:13:40,319 --> 00:13:41,620 to collaborate to, 378 00:13:42,159 --> 00:13:43,379 really be at the forefront 379 00:13:44,079 --> 00:13:45,059 of early stage 380 00:13:45,679 --> 00:13:46,179 treatments 381 00:13:46,639 --> 00:13:48,019 for heart and lung problems. 382 00:13:48,639 --> 00:13:50,639 So we're really looking forward to that as 383 00:13:50,639 --> 00:13:52,695 both a challenge and an opportunity for us. 384 00:13:54,054 --> 00:13:55,575 That makes a lot of sense. And, you 385 00:13:55,575 --> 00:13:56,695 know, it is really, 386 00:13:57,095 --> 00:13:59,495 interesting to see how those dynamics have been 387 00:13:59,495 --> 00:14:02,375 shifting. And I know it's, you know, no 388 00:14:02,375 --> 00:14:03,674 small task to, 389 00:14:04,774 --> 00:14:07,674 have those types of clinical trials and research 390 00:14:07,815 --> 00:14:08,475 and more, 391 00:14:08,889 --> 00:14:10,649 becoming a bigger part of what you're doing 392 00:14:10,649 --> 00:14:13,129 there. And I I'm curious, when you think 393 00:14:13,129 --> 00:14:15,450 of that balance between trying new things and 394 00:14:15,450 --> 00:14:18,250 the research and the development and accelerating therapies 395 00:14:18,250 --> 00:14:20,970 and, you know, also knowing that you have 396 00:14:20,970 --> 00:14:22,865 to to care for a a growing patient 397 00:14:22,865 --> 00:14:25,204 base, how do you keep the the, 398 00:14:25,985 --> 00:14:28,704 both innovation as well as clinical quality and 399 00:14:28,704 --> 00:14:31,105 safety in mind and, you know, looking ahead 400 00:14:31,105 --> 00:14:33,184 as well as thinking about what needs to 401 00:14:33,184 --> 00:14:34,529 be done right in front of you? 402 00:14:35,250 --> 00:14:38,230 We have a a beautiful strategic road map, 403 00:14:39,250 --> 00:14:41,009 and we actually have changed it into a 404 00:14:41,009 --> 00:14:42,070 visual that, 405 00:14:42,769 --> 00:14:45,009 that looks like four pillars holding up a 406 00:14:45,009 --> 00:14:47,750 temple. You've seen that visual before for strategies 407 00:14:48,184 --> 00:14:49,084 with the foundation, 408 00:14:49,384 --> 00:14:52,424 four pillars, and then the the capstone on 409 00:14:52,424 --> 00:14:52,924 top. 410 00:14:53,464 --> 00:14:55,464 And the capstone has our vision, which is 411 00:14:55,464 --> 00:14:57,945 that we wanna be nationally ranked, recognized for 412 00:14:57,945 --> 00:15:00,424 what we do, and being a destination for 413 00:15:00,424 --> 00:15:00,924 compassionate 414 00:15:01,304 --> 00:15:03,004 and collaborative and innovative 415 00:15:03,370 --> 00:15:04,750 heart and vascular care, 416 00:15:05,210 --> 00:15:07,929 now heart, lung, and vascular care. And the 417 00:15:07,929 --> 00:15:10,910 strategic pillars have to do with exceptional quality, 418 00:15:11,529 --> 00:15:13,230 being brilliant at our operational 419 00:15:13,769 --> 00:15:14,269 capabilities, 420 00:15:15,290 --> 00:15:18,830 focusing and elevating research and education, and lastly, 421 00:15:19,585 --> 00:15:20,644 strategic growth. 422 00:15:21,424 --> 00:15:24,465 And whenever we have a group meeting, a 423 00:15:24,465 --> 00:15:25,524 strategy meeting, 424 00:15:26,065 --> 00:15:28,384 or an operational meeting that's more related to 425 00:15:28,384 --> 00:15:30,485 tactics, we show the same slide 426 00:15:30,865 --> 00:15:33,664 and have people really coalesce around. These are 427 00:15:33,664 --> 00:15:34,644 our four pillars. 428 00:15:35,024 --> 00:15:36,519 This This is what we'll work on, what 429 00:15:36,519 --> 00:15:37,579 we'll focus on. 430 00:15:38,039 --> 00:15:40,860 And below, we have the number of metrics 431 00:15:41,639 --> 00:15:42,139 and 432 00:15:42,440 --> 00:15:42,940 tactics 433 00:15:43,319 --> 00:15:46,120 that are related to those pillars. So getting 434 00:15:46,120 --> 00:15:47,100 the team members 435 00:15:47,720 --> 00:15:48,220 aligned 436 00:15:48,695 --> 00:15:50,934 in a way that they can see that 437 00:15:50,934 --> 00:15:51,595 their work 438 00:15:52,134 --> 00:15:52,634 affects 439 00:15:53,014 --> 00:15:54,394 either one or multiple 440 00:15:55,014 --> 00:15:57,975 strategic pillars that we have and then allows 441 00:15:57,975 --> 00:16:00,214 us to move forward because of their work, 442 00:16:00,214 --> 00:16:02,955 I think, is very impactful, keeps people engaged, 443 00:16:03,389 --> 00:16:05,950 keeps people and the team aligned to what 444 00:16:05,950 --> 00:16:07,330 our future is gonna be. 445 00:16:08,110 --> 00:16:10,750 That's helpful for understanding. Thank you so much 446 00:16:10,750 --> 00:16:12,590 for digging a little bit deeper there. Now 447 00:16:12,590 --> 00:16:14,110 before we wrap up, I wanted to ask 448 00:16:14,110 --> 00:16:15,790 you about growth too, where do you see 449 00:16:15,790 --> 00:16:17,870 some of the best opportunities for organizational growth 450 00:16:17,870 --> 00:16:19,125 in the next year or two? 451 00:16:19,605 --> 00:16:21,605 Yeah. I think the the biggest potential, quite 452 00:16:21,605 --> 00:16:22,725 frankly, Laura, is the, 453 00:16:23,445 --> 00:16:23,945 the, 454 00:16:24,565 --> 00:16:25,065 possibility, 455 00:16:26,085 --> 00:16:28,585 that we've been talking about for some time 456 00:16:29,284 --> 00:16:29,945 of really, 457 00:16:30,965 --> 00:16:32,345 really having a 458 00:16:33,250 --> 00:16:33,750 collaborative 459 00:16:34,449 --> 00:16:35,750 Pan Michigan approach 460 00:16:36,209 --> 00:16:37,829 to heart and vascular care. 461 00:16:38,289 --> 00:16:40,149 And what do I mean by that? Well, 462 00:16:40,449 --> 00:16:42,769 big system on West in West Michigan, that 463 00:16:42,769 --> 00:16:45,649 Spectrum Health, that was the organization that I 464 00:16:45,649 --> 00:16:48,535 joined based out of Grand Rapids, big system 465 00:16:48,535 --> 00:16:49,915 on the East part of the state, Legacy 466 00:16:51,254 --> 00:16:53,754 Beaumont based out of Metro Detroit. 467 00:16:54,134 --> 00:16:56,295 Now we're Coral Health West and Coral Health 468 00:16:56,295 --> 00:16:56,795 East. 469 00:16:57,654 --> 00:16:59,355 Well, if we can collaborate 470 00:17:00,230 --> 00:17:02,169 and really align on 471 00:17:02,949 --> 00:17:06,089 different protocols, algorithms for patient care, 472 00:17:06,710 --> 00:17:08,409 I think we could have a huge impact 473 00:17:08,549 --> 00:17:11,029 on not just our local communities, but really 474 00:17:11,029 --> 00:17:12,569 the whole Michigan population. 475 00:17:13,109 --> 00:17:14,890 Whether we talk about heart failure, 476 00:17:16,825 --> 00:17:17,325 eligibility 477 00:17:17,625 --> 00:17:18,605 for heart transplant, 478 00:17:19,704 --> 00:17:21,164 we talk about shock 479 00:17:21,704 --> 00:17:22,204 and 480 00:17:22,505 --> 00:17:23,005 emerging 481 00:17:23,464 --> 00:17:26,265 strategies to deal with patients in cardiogenic shock, 482 00:17:26,265 --> 00:17:28,044 including advanced mechanical 483 00:17:28,345 --> 00:17:29,565 circulatory support. 484 00:17:30,250 --> 00:17:32,429 We talk about peripheral arterial disease 485 00:17:33,289 --> 00:17:35,150 and how we treat patients with 486 00:17:36,009 --> 00:17:36,509 claudication 487 00:17:36,970 --> 00:17:38,109 all the way to 488 00:17:38,650 --> 00:17:39,950 limb threatening ischemia. 489 00:17:40,809 --> 00:17:43,045 We talk about wound care. We talk about 490 00:17:43,045 --> 00:17:45,465 coronary disease. All these different entities 491 00:17:46,404 --> 00:17:47,224 that we see 492 00:17:47,525 --> 00:17:50,184 in our so many hospitals across Michigan, 493 00:17:50,724 --> 00:17:52,884 if we can coordinate that care in a 494 00:17:52,884 --> 00:17:55,045 way that's more meaningful, that could have a 495 00:17:55,045 --> 00:17:57,500 really big impact, I think, for many of 496 00:17:57,500 --> 00:17:59,000 the folks that we take care of. 497 00:17:59,779 --> 00:18:00,279 Absolutely. 498 00:18:00,740 --> 00:18:02,259 It that makes a lot of sense, and 499 00:18:02,259 --> 00:18:04,340 you really paints a great picture of what's 500 00:18:04,340 --> 00:18:04,840 ahead, 501 00:18:05,220 --> 00:18:07,700 and the possibilities for you at Corwell. Thank 502 00:18:07,700 --> 00:18:09,404 you so much for joining us on the 503 00:18:09,565 --> 00:18:11,724 podcast today, doctor Kashyap. It's been a pleasure 504 00:18:11,724 --> 00:18:13,164 speaking with you. I I've learned a lot, 505 00:18:13,164 --> 00:18:14,205 and I look forward to seeing you as 506 00:18:14,205 --> 00:18:15,724 well at our annual meeting in April. I 507 00:18:15,724 --> 00:18:17,244 know you'll be speaking on a panel and 508 00:18:17,244 --> 00:18:19,244 really digging deeper into some of these themes 509 00:18:19,244 --> 00:18:21,005 we've been talking about, so I'm excited to 510 00:18:21,005 --> 00:18:22,845 have you as part of it. Well, thank 511 00:18:22,845 --> 00:18:24,445 you. It's been my pleasure, Laura. I really 512 00:18:24,445 --> 00:18:25,345 appreciate it.