1 00:00:00,375 --> 00:00:02,825 - This is Laura Dedo with the Becker's Healthcare Podcast. 2 00:00:03,445 --> 00:00:04,985 I'm thrilled today to be joined by Dr. 3 00:00:05,015 --> 00:00:08,345 Abraham Barda, who's a system chief of hospital medicine 4 00:00:08,445 --> 00:00:09,785 and regional Chief Medical 5 00:00:09,885 --> 00:00:11,625 and Quality Officer at Baystate Health. 6 00:00:12,005 --> 00:00:14,425 Dr. Barda, it's a pleasure to have you on the podcast today, 7 00:00:15,835 --> 00:00:16,835 - Laura. 8 00:00:16,835 --> 00:00:17,505 Thank you very much for having me 9 00:00:17,505 --> 00:00:21,025 and for Becker uh, health for this great opportunity. 10 00:00:22,845 --> 00:00:24,325 - Absolutely. And well, I'm looking forward 11 00:00:24,325 --> 00:00:26,205 to our conversation and learning more about 12 00:00:26,345 --> 00:00:28,405 how you're growing and developing at Baystate 13 00:00:28,545 --> 00:00:29,765 and some of the things you're doing around 14 00:00:29,765 --> 00:00:30,805 value-based care as well. 15 00:00:30,865 --> 00:00:32,045 But before we dive into that, 16 00:00:32,185 --> 00:00:33,205 can you tell us a little bit more 17 00:00:33,205 --> 00:00:34,365 about yourself and your background? 18 00:00:35,895 --> 00:00:39,055 - Absolutely. Um, uh, Abram Barda, I'm a clinician 19 00:00:39,055 --> 00:00:42,255 with capital C and an executive by trade. 20 00:00:42,395 --> 00:00:45,015 Um, um, currently the system chief, um, 21 00:00:45,195 --> 00:00:46,815 and the regional chief, uh, medical 22 00:00:46,955 --> 00:00:49,575 and quality officer for Baystate Health in Massachusetts. 23 00:00:50,235 --> 00:00:51,935 Uh, Baystate Health is, uh, 24 00:00:52,095 --> 00:00:54,015 a five hospital system in western Mass. 25 00:00:54,075 --> 00:00:58,695 We serve collectively around 900, uh, thousand patients, 26 00:00:58,995 --> 00:01:02,295 uh, throughout western mass and, uh, the New England area. 27 00:01:02,595 --> 00:01:05,975 Uh, we are integrated teaching hospital network, uh, 28 00:01:05,975 --> 00:01:08,815 with an academic regional site of UMass, uh, 29 00:01:08,845 --> 00:01:09,855 Chan Medical school. 30 00:01:10,475 --> 00:01:15,415 Um, like everybody who, uh, been in clinical medicine, um, 31 00:01:15,595 --> 00:01:18,455 uh, clinician, I practice inpatient medicine, 32 00:01:18,735 --> 00:01:20,775 hospital medicine in an academic setting. 33 00:01:20,995 --> 00:01:25,935 Um, uh, after I, um, finished my, uh, clinical training, I, 34 00:01:26,475 --> 00:01:30,695 uh, took, uh, a little bit more of, um, uh, the task 35 00:01:30,715 --> 00:01:33,815 of learning about clinical research, the outcome, uh, 36 00:01:34,335 --> 00:01:37,615 specific research of healthcare delivery that led me 37 00:01:37,615 --> 00:01:40,615 to more quality training, to more finance, um, 38 00:01:40,835 --> 00:01:41,935 and MBA training, 39 00:01:42,035 --> 00:01:44,815 and led me to think a little bit about how we can 40 00:01:45,575 --> 00:01:46,975 redesign the system, um, 41 00:01:47,275 --> 00:01:48,935 and make it better for our patient, 42 00:01:49,085 --> 00:01:50,575 make it more patient centric. 43 00:01:51,075 --> 00:01:55,295 Uh, I moved across couple, um, uh, systems in Massachusetts, 44 00:01:55,555 --> 00:01:57,815 uh, mass General, um, uh, 45 00:01:57,815 --> 00:01:59,375 Brigham Women's Hospital in Boston, 46 00:01:59,555 --> 00:02:03,055 and now I'm Baystate where, uh, I see, uh, more 47 00:02:03,055 --> 00:02:05,295 of the system level, uh, function 48 00:02:05,295 --> 00:02:06,335 of the healthcare delivery. 49 00:02:08,125 --> 00:02:09,375 - Well, that's amazing to hear. 50 00:02:09,435 --> 00:02:11,375 And you know, certainly some great experiences 51 00:02:11,485 --> 00:02:12,975 that you've had throughout your career. 52 00:02:13,465 --> 00:02:16,015 Could you tell me about the most successful project 53 00:02:16,205 --> 00:02:17,415 from the last year or two? 54 00:02:17,645 --> 00:02:19,615 What did you do and how did you measure results? 55 00:02:21,855 --> 00:02:25,205 - Great question, Laura. Um, for the past year, I've been, 56 00:02:25,345 --> 00:02:29,125 uh, quite, uh, consumed by how we can systemize 57 00:02:29,185 --> 00:02:32,885 and standardize and the, the, the whole notion here, 58 00:02:32,985 --> 00:02:35,725 and I'm gonna hone in more of the inpatient delivery 59 00:02:35,785 --> 00:02:38,925 of the care and not just take the whole system and, 60 00:02:38,985 --> 00:02:42,965 and try to rethink about the design, is, uh, how we can, uh, 61 00:02:43,095 --> 00:02:47,245 focus on the patient throughout their journey, um, in that, 62 00:02:47,305 --> 00:02:51,965 in that complex inpatient, uh, services that we do to serve, 63 00:02:52,225 --> 00:02:54,725 uh, uh, the best interest for the patient. 64 00:02:55,185 --> 00:02:58,325 So my goal here is, uh, uh, to, uh, 65 00:02:58,475 --> 00:03:00,845 make sure we have a patient flow governance. 66 00:03:01,265 --> 00:03:05,005 Uh, as a background, we all talk about hospital capacity, 67 00:03:05,105 --> 00:03:07,885 how we can manage the access to care for the inpatient. 68 00:03:08,505 --> 00:03:12,045 Uh, my job was, um, uh, to be part of bigger team 69 00:03:12,185 --> 00:03:16,565 to think about that, um, the crowd, uh, uh, status 70 00:03:16,595 --> 00:03:19,605 that we have always in emergency, um, department, 71 00:03:19,605 --> 00:03:20,885 and how we can take that 72 00:03:21,065 --> 00:03:24,965 and, uh, aim to deliver the best quality care 73 00:03:25,065 --> 00:03:28,965 and implement, uh, stages for the patient to come 74 00:03:28,965 --> 00:03:32,485 through our emergency department from any of our sites 75 00:03:32,545 --> 00:03:35,885 and go through a care delivery for the inpatient 76 00:03:36,185 --> 00:03:38,485 and aim to reduce length of stay, 77 00:03:38,705 --> 00:03:41,765 get the right patient in the right bed for the right care, 78 00:03:42,265 --> 00:03:44,925 and always measure that quality, um, the, 79 00:03:44,945 --> 00:03:48,445 the value-based care where we deliver the best quality for, 80 00:03:48,905 --> 00:03:51,645 uh, the reasonable or the lower cost to reach that value. 81 00:03:52,345 --> 00:03:55,925 Um, Laura, we've been, we've been measuring it with 82 00:03:56,445 --> 00:03:57,565 multiple, uh, tools. 83 00:03:58,065 --> 00:04:01,925 Uh, the outcomes, what we, what we always focus on, 84 00:04:02,025 --> 00:04:05,485 but I challenge my team to also think about the processes, 85 00:04:06,025 --> 00:04:09,565 how the patient could initiate care earlier, IE when, uh, 86 00:04:09,585 --> 00:04:14,005 any of us would go through the emergency medicine, uh, part, 87 00:04:14,145 --> 00:04:17,165 how we can get to that patient faster, uh, 88 00:04:17,345 --> 00:04:19,325 for any reason they could come, we can measure 89 00:04:19,355 --> 00:04:20,445 that in the minutes and 90 00:04:20,445 --> 00:04:22,565 how we can get the patient in the right bed, 91 00:04:22,825 --> 00:04:27,205 and how we can gauge that team, uh, to initiate care faster 92 00:04:27,385 --> 00:04:30,365 and how that lengthy stay will start look better. 93 00:04:31,025 --> 00:04:33,165 Um, at the same time, we wanted 94 00:04:33,185 --> 00:04:34,765 to also focus on the patient. 95 00:04:35,185 --> 00:04:37,845 So we always measure patient satisfaction, uh, 96 00:04:37,945 --> 00:04:39,365 the standardized metric. 97 00:04:39,745 --> 00:04:41,885 And then, uh, when I take it a step further, 98 00:04:41,985 --> 00:04:45,845 we start looking at the satisfaction for the caregiver 99 00:04:45,905 --> 00:04:48,885 for nursing clinicians, the frontline providers. 100 00:04:49,265 --> 00:04:50,805 You can optimize the system, 101 00:04:50,905 --> 00:04:54,365 but you also need to keep your team in the middle, uh, 102 00:04:54,455 --> 00:04:55,845 while you're looking at the safety 103 00:04:55,945 --> 00:04:57,925 to experience the clinical quality and, 104 00:04:57,925 --> 00:04:59,725 and the value as a, as a whole. 105 00:05:00,185 --> 00:05:04,325 Um, we build a platform for, uh, the measurement where, uh, 106 00:05:04,385 --> 00:05:06,725 our senior leadership would be also engaged in 107 00:05:06,725 --> 00:05:11,005 that performance and we can get more direction, uh, 108 00:05:11,265 --> 00:05:12,285 to optimize. 109 00:05:12,705 --> 00:05:16,565 So, um, that, if I had to summarize it, the two s models, 110 00:05:16,995 --> 00:05:20,405 systemization and standardization would be the combination 111 00:05:20,505 --> 00:05:23,445 of, uh, bring the excellence in operation, 112 00:05:23,455 --> 00:05:24,685 bring the digital health, 113 00:05:24,905 --> 00:05:26,965 and how we can measure that, uh, 114 00:05:27,125 --> 00:05:29,165 throughout the phases of care. 115 00:05:29,625 --> 00:05:31,805 And of course, the importance of having 116 00:05:31,835 --> 00:05:33,085 that layer of quality. 117 00:05:33,585 --> 00:05:38,405 Um, we will be also, uh, uh, sharing our experience in terms 118 00:05:38,405 --> 00:05:40,285 of the patient flow governance 119 00:05:40,665 --> 00:05:43,285 and our outcomes that we led here at Baystate Health. 120 00:05:45,415 --> 00:05:46,555 - Wow, that's great to hear. 121 00:05:46,815 --> 00:05:49,875 And certainly just some fascinating, um, results 122 00:05:49,875 --> 00:05:53,475 that are coming from, um, your initiative to, um, make sure 123 00:05:53,475 --> 00:05:54,955 that patients are getting the right care 124 00:05:55,375 --> 00:05:57,460 and, um, in the right place at the right time. 125 00:05:57,805 --> 00:05:59,365 I think it is certainly something that 126 00:05:59,785 --> 00:06:03,405 so many different organizations, um, are, are aiming for 127 00:06:03,505 --> 00:06:05,125 and, and feel like that's a, 128 00:06:05,205 --> 00:06:07,965 a really an important imperative over the next few years. 129 00:06:08,665 --> 00:06:11,045 Now, when you're looking at what you're at today, 130 00:06:11,045 --> 00:06:12,285 what are some of your top priorities 131 00:06:12,285 --> 00:06:13,485 for the next 12 months or so? 132 00:06:13,485 --> 00:06:15,205 What's really top of mind for you? 133 00:06:16,955 --> 00:06:20,535 - If I had to, uh, share that, uh, with the audience, Laura, 134 00:06:20,835 --> 00:06:25,375 uh, we all thinking about, uh, how the value, 135 00:06:25,715 --> 00:06:29,495 um, uh, care, the, the, the value based care, uh, 136 00:06:29,605 --> 00:06:31,135 that we are aiming all to deliver. 137 00:06:31,755 --> 00:06:34,895 Uh, the goal here is for us, the challenge, 138 00:06:35,615 --> 00:06:39,495 everyone in the system after we've seen many, many slices 139 00:06:39,495 --> 00:06:43,375 of the data that we could do a safe care in the hospital, 140 00:06:43,395 --> 00:06:45,415 you're probably familiar with, uh, 141 00:06:45,415 --> 00:06:49,255 many studies retrospectively collected outcomes, um, about 142 00:06:49,435 --> 00:06:51,495 how we could do what we do better in terms 143 00:06:51,495 --> 00:06:52,695 of the quality and safety. 144 00:06:53,835 --> 00:06:57,895 So, uh, that would be absolutely in the core of the mission 145 00:06:58,115 --> 00:07:02,215 of how we can care for the patient with the best, uh, 146 00:07:02,735 --> 00:07:05,255 approach, patient centric, cost efficient, 147 00:07:05,255 --> 00:07:07,255 and the sustainability of healthcare delivery, 148 00:07:07,255 --> 00:07:09,935 especially in the light of, uh, uh, 149 00:07:10,045 --> 00:07:11,215 what we're seeing in terms 150 00:07:11,215 --> 00:07:13,815 of the financial instability subsystems. 151 00:07:14,235 --> 00:07:17,775 Um, I, I would like always to, uh, say innovation, 152 00:07:17,955 --> 00:07:20,415 but that might hold me back a little bit 153 00:07:20,415 --> 00:07:24,175 because we want to make sure that we're meeting, uh, 154 00:07:24,355 --> 00:07:26,135 the standard of care, to say the least. 155 00:07:26,155 --> 00:07:29,015 As a clinician, I always hold myself accountable 156 00:07:29,035 --> 00:07:32,575 for standard of care and then make sure that is, um, 157 00:07:33,145 --> 00:07:34,975 systemized across our system. 158 00:07:35,115 --> 00:07:39,135 So, like probably everyone in the country, we're, we're part 159 00:07:39,135 --> 00:07:42,975 of integrated teaching academic network where we need 160 00:07:42,975 --> 00:07:47,495 to have the complex patients, uh, in a specific, uh, uh, 161 00:07:47,645 --> 00:07:49,135 beds on specific services. 162 00:07:49,475 --> 00:07:54,255 So the systemization is, is the second layer of my priority 163 00:07:54,255 --> 00:07:58,135 where, uh, let's be sure collectively that we're, uh, 164 00:07:58,185 --> 00:08:02,055 delivering the care that, uh, decision to treat the, 165 00:08:02,275 --> 00:08:04,815 the team buildup would be matching, uh, 166 00:08:04,845 --> 00:08:08,935 what our patients they're asking for and how our providers 167 00:08:09,035 --> 00:08:12,055 and, and, um, um, stakeholders, 168 00:08:12,055 --> 00:08:13,975 they're also part of that engagement. 169 00:08:14,315 --> 00:08:16,695 Uh, we've been faced with a lot of, uh, burnout. 170 00:08:17,315 --> 00:08:20,335 Uh, we want to make sure we also care for the team. 171 00:08:20,435 --> 00:08:24,335 So in the core of what we do, uh, is, uh, value-based care, 172 00:08:24,915 --> 00:08:28,375 uh, the layer of the systemization and the care delivery 173 00:08:28,475 --> 00:08:29,815 and the access to the care 174 00:08:30,315 --> 00:08:33,615 and what brings it together is our wellbeing, our, 175 00:08:33,835 --> 00:08:37,695 our approach to make sure we build a sustainable healthcare 176 00:08:38,315 --> 00:08:41,015 in the community, in, uh, the teaching hospitals 177 00:08:41,015 --> 00:08:43,535 and academic medical center, and have it as a continuum. 178 00:08:45,575 --> 00:08:46,595 - That's amazing here. 179 00:08:46,595 --> 00:08:49,155 And absolutely, you know, just so critical, um, 180 00:08:49,455 --> 00:08:51,395 as you were saying, to have that standardized 181 00:08:51,415 --> 00:08:55,725 and systematized, um, approach to care 182 00:08:55,785 --> 00:08:57,365 and quality of care to achieve 183 00:08:57,365 --> 00:08:58,605 the outcomes that you're looking for. 184 00:08:59,025 --> 00:09:01,725 Um, I, I think it's so crucial and helpful to see 185 00:09:01,865 --> 00:09:03,925 and think about how you're looking at that 186 00:09:04,025 --> 00:09:06,525 and building strong teams and systems for the future. 187 00:09:07,065 --> 00:09:08,885 Now, before we wrap up here, I'm wondering, 188 00:09:08,945 --> 00:09:10,485 how do you anticipate your role 189 00:09:10,505 --> 00:09:12,005 and teams will change in the future? 190 00:09:12,375 --> 00:09:14,325 We've talked about some of the changes happening in the 191 00:09:14,325 --> 00:09:17,285 healthcare space, and certainly, um, a lot of, you know, 192 00:09:17,385 --> 00:09:20,565 the, the challenges as well as opportunities, um, can, 193 00:09:20,745 --> 00:09:22,045 can really be helpful, 194 00:09:22,265 --> 00:09:24,805 but also are transformative on the health system level. 195 00:09:26,815 --> 00:09:29,075 - Um, that is, that's an excellent question 196 00:09:29,075 --> 00:09:32,675 because I, I would, healthcare will not be static. 197 00:09:33,095 --> 00:09:37,675 We need to be, um, uh, dealing with that agility of 198 00:09:37,705 --> 00:09:40,555 what our patient needs, how the environment around us, 199 00:09:40,575 --> 00:09:43,595 and especially coming out of, uh, the covid zone. 200 00:09:43,695 --> 00:09:45,555 And, and again, we're gonna go back 201 00:09:45,555 --> 00:09:47,595 to the financial stability and the access 202 00:09:47,595 --> 00:09:50,435 and sustainability of our, uh, industry. 203 00:09:51,055 --> 00:09:54,555 Um, personally, I see, um, my role 204 00:09:54,615 --> 00:09:58,715 and my team, there will be more system level where we need 205 00:09:58,715 --> 00:10:00,035 to look at the system as a whole. 206 00:10:00,135 --> 00:10:03,995 We need to, um, innovate more of that healthcare delivery. 207 00:10:04,535 --> 00:10:08,395 Uh, for, for, um, specific, um, 208 00:10:09,155 --> 00:10:13,475 examples is, uh, how we can, um, lower the cost, 209 00:10:13,695 --> 00:10:17,235 how we can, uh, sustain the nursing staffing, 210 00:10:17,335 --> 00:10:21,675 how we can build a team that we know we, uh, uh, 211 00:10:21,815 --> 00:10:23,155 all suffered during covid 212 00:10:23,335 --> 00:10:26,435 and how that would look like for the patient side. 213 00:10:26,775 --> 00:10:28,675 Uh, the regulations also that coming, 214 00:10:28,945 --> 00:10:32,915 that would also require us to, uh, think about how we can, 215 00:10:33,335 --> 00:10:37,395 uh, do better and how our, uh, trends and, and, 216 00:10:37,535 --> 00:10:41,835 and the, the patient coming to, uh, our hospitals, 217 00:10:41,835 --> 00:10:45,355 to our clinics, to our urgent care will be cared 218 00:10:45,415 --> 00:10:46,955 for 24 uh, hours. 219 00:10:47,575 --> 00:10:50,155 The, the one thing, um, the one thing glad 220 00:10:50,155 --> 00:10:53,755 that I would like also to share that, uh, that, uh, 221 00:10:53,845 --> 00:10:55,555 chief uh, medical, uh, 222 00:10:55,695 --> 00:10:58,275 and quality officer role is also evolving. 223 00:10:58,325 --> 00:11:01,995 There, there, um, many articles, uh, about 224 00:11:02,215 --> 00:11:05,595 how we can also bring, uh, more of that, uh, 225 00:11:06,055 --> 00:11:07,635 system level thinker 226 00:11:08,255 --> 00:11:11,355 and be able to connect the way we do, uh, 227 00:11:11,405 --> 00:11:15,235 throughout our meetings, throughout the Becker platform, uh, 228 00:11:15,735 --> 00:11:17,915 to, uh, rethink and bring it back home 229 00:11:18,055 --> 00:11:20,395 and say, okay, this is working, this is not working. 230 00:11:20,535 --> 00:11:24,595 How we can change and, uh, keep innovate what we're doing. 231 00:11:26,705 --> 00:11:27,705 - I love that. Dr. 232 00:11:27,955 --> 00:11:29,185 Barta, thank you so much for joining 233 00:11:29,185 --> 00:11:30,345 us on the podcast today. 234 00:11:30,365 --> 00:11:32,785 It, it's really fascinating to hear how that chief medical 235 00:11:32,845 --> 00:11:34,785 and quality officer role, um, you know, 236 00:11:34,785 --> 00:11:36,705 really is important on the system level 237 00:11:36,725 --> 00:11:39,425 and has been growing in how you can think strategically 238 00:11:39,425 --> 00:11:40,585 and make an impact on patients. 239 00:11:40,585 --> 00:11:43,625 And then too, to look at, you know, on the value side, 240 00:11:43,685 --> 00:11:45,345 the outcomes and, and the quality. 241 00:11:45,525 --> 00:11:48,385 Um, just really being elevated is so refreshing to hear. 242 00:11:48,395 --> 00:11:50,625 Thank you so much for joining us on the podcast today. 243 00:11:50,775 --> 00:11:52,185 This has been a fun conversation 244 00:11:52,205 --> 00:11:54,025 and I look forward to connecting with you again soon. 245 00:11:55,105 --> 00:11:56,695 - Thank you very much for having me, Laura, 246 00:11:56,875 --> 00:11:58,495 and I hope we connect very soon.