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Hi. Welcome to the Becker's Healthcare podcast.
My name is Paige Twenter. I'm an assistant
editor here at Becker's Healthcare.
I'm thrilled to interview Andy today.
Thank you so much for joining me. Before
we dive in, I'd love to have you
introduce yourself and tell us about your background.
Sounds great. Thank you.
I am, Andy Anderson. I'm a a physician.
I'm a general
internist,
by training, and I've worked as a a
hospitalist
and
continue to do work as a primary care
physician. And
I am the chief medical officer and chief
quality
officer for RWJBarnabas
Health,
in New Jersey,
which is a a health system with,
12 adult hospitals and about $7,000,000,000
in in revenue. And and my my role
here is is essentially
heavily focused on quality, safety, and
patient experience,
and also
have oversight of our academic partnership with,
Rutgers with regards to our training programs for
future,
health care professionals, including physicians in in our
research infrastructure.
So excited to to speak with you today.
Yeah. Yeah. Same. Can you tell the audience,
you know, a bit about
in the past, you know, 6 months to
last year, what has been the most successful
project or initiative? You know, what what was
it and what were the results?
Yeah. We've we've been very focused on providing
the the best
outcomes for for our patients and and for
our communities and and working on
our patient experience
and also on mortality. So I'll focus on
mortality,
which of course is
very important
and we've worked on
the outcome side with regards to,
preventing patients from from dying,
but also on the documentation side to make
sure we're accurately
capturing
how sick patients are so that their electronic
health record is is up to date
and more easily communicated,
you know, across the health care team. We've
seen a significant
result. We've reduced our mortality
by over 20% over the past couple of
years by really focusing on
a few things.
One of them is is sepsis. Sepsis is
the
the infection
situation that results in death, and about a
third of our deaths are are related to
that. And so making sure that we're recognizing
sepsis
as soon as possible
and then intervening,
you know, as soon as possible.
One of the opportunities there has been our
electronic health record, which is Epic, which has
an alert system, which in turn goes to
our rapid response team who is able to
act quickly
and intervene appropriately with things like antibiotics and
and fluids.
We also have,
AI tool called the deterioration index embedded in
EPIC, which predicts for us if someone's likely
to die.
And that tool, in turn, also provides the
opportunity for our rapid response team and our
floor teams to truly go and assess the
patient real time and intervene real time so
that we can make sure someone doesn't get
sicker and make sure they are getting the
care that they need,
right away. So a lot of good work
on our alert system,
a lot of good work on making sure
that we are rescuing patients who are getting
sicker, a lot of good work on making
sure that our patients are giving evidence based
care and and best practice guidelines to make
sure they get to the best outcomes.
Yeah. 20%
drop is pretty significant. Was it only sepsis,
or were there other
conditions you all were focusing on?
Yes. It was across the board, in terms
of the the 20%. Sepsis was a a
big area of focus. We also spent
a lot of time working on, the mortality
review process. When someone does,
die, we're able to really go back and
see are there things we can learn from
this, and then in turn, share that back
to the team that was caring for the
patient as well as share it as a
system learning
so that that others can can also learn
from it in in the future.
We've also done a lot of work on
our ICUs in terms of our ventilator management,
making sure that we are extubating patients timely,
making sure that we're
doing things like raising the head of the
bed, making sure that we're providing really the
best possible care for patients who who are
already sick to make sure that they have
the best chance of getting better.
And with $7,000,000,000
revenue and 12 hospitals,
how do you,
really ensure excellence, like and
focus on, you know, these kind of wide
scaling big hairy goals?
Yeah. Part of it is is articulating
the why, you know, why this is important
and and really engaging
our leaders and our frontline
caregivers
in the work and making sure that we're
all doing the right thing, that we're following
those those best practices. And, you know, part
of our success I attribute to a team
based
approach, and we purposely
had our chief medical officers, which are our
doctor leaders, our chief nursing officers, our nurse
leaders, as well as our our quality
leaders really partnering
together.
They're at the table together. They're making sure
that they are identifying
those best practices, those pathways that are gonna
provide the best outcomes for patients.
And then making sure that we're all doing
it and and really sharing results and trying
to lift each other up. If one hospital
is doing better in a certain area, we
make sure that hospital shares what they're doing.
Another hospital is is not doing well, then
we have that hospital talk about their challenges
and we we problem solve together. So really
working together, sharing best practices, and truly operating
as an integrated health system is making an
enormous difference for us.
On the vein of sharing best practices and,
you know, problem solving when challenges arise,
whether it's with the recent efforts of, reducing
mortality
or,
you know, something else with their recent challenge
that
r j w RWJBarnabas
recently overcame?
Yeah. I think
the the opportunity for us is is really
to reengage
our doctors and and our nurses and our
our health care professionals.
There was a lot of stress,
from from COVID,
from the financial challenges that all health systems
had as we were coming out of COVID.
There's there's just a lot going on in
in health care, a lot of change, and
so that that intensity,
has caused some of our clinicians to to
burn out. And and so we have a
lot of focus on on wellness
and making sure that we're supporting
our doctors and our nurses and and all
of our staff for that matter, in their
work. Part of that goes back
to having them feel the why, why this
is important, you know, why they come to
work, and that's very engaging. Part of it
is trying to make sure that we're making
it easier
for everybody to to do their work. Part
of that is the electronic health record and
and making sure
that the EMR is is easier to use
for our clinicians.
Part of it is just making sure that
we are supporting each other,
recognizing each other, and thanking each other, you
know, appreciating
the team that's doing work, you know, makes
a huge difference. So
really reengaging,
and ultimately activating, you know, getting our clinicians
and our staff excited about the work they're
doing. That's what we're after and part of
that is measured through our annual engagement survey
and we saw a big jump in those
results last year, which is is really important
for us because it really takes a fully
engaged workforce to be able to deliver
the best possible outcomes.
Are you thinking of recent example of addressing
that burnout and forcing the why or reengaging
your nurses and physicians? Was there
something in particular you had in mind?
Yeah. We've established we call them, wellness
committees.
Each of our
hospitals,
established
a a group,
that would be a a opportunity to listen
to issues that come up,
in in the hospital. Some of them are
little things, simple things that can be
easily fixed. Some of them are are more
complicated,
but having that that forum,
to to share,
challenges and to share stresses
and then and working the list and trying
to fix problems,
as best we can. The other,
tool that I find very powerful is we
call it senior leader rounds,
where the hospital c suite, you know, goes
out to the hospital floors,
meets with the staff, listens
to any issues or concerns they have. Sometimes
it's things like the supply chain function
is not correctly working. You know, there's certain
tools that that are not in place that
need to be there.
And some of those things can be fixed
real time, which is very powerful to to
see your c suite, you know, fixing your
problem when you're a staff member on a
on a floor unit.
So that's been another great tool for us
to help problem solve and and to help
make the work environment easier for everybody.
Mhmm. Yeah. I can only mention how encouraging
it is to be, like, that real time
fix. Like, as soon as the problem is
raised, you know, and not waiting and emails
and weeks weeks for something to be over
with.
We have a few minutes left. I wanna
make sure I get to a few other
questions. So I'm gonna give you 2 questions
at once. One is, you know, how do
you see the chief medical and quality officer
roles evolving? And then also,
to tack on what would be your advice
for future aspiring,
chief medical and quality officers?
Yeah. The the chief medical officer role,
I think will evolve to be
more of a strategic,
you know, business partner
as a c suite member
within a hospital or within a health system
where the chief medical officer,
who is really the physician leader,
gets more involved in in all aspects of
decision making. You know, the physician
leader needs to understand the business, and and
part of that is is my advice to
aspiring
CMOs is to understand the entirety of the
health care business.
Not that someone's gonna become a full subject
matter expert in the finances of health care
or, you know, how human resources,
should work in a health system, but
having deeper knowledge and experience and exposure
to those different
functions is very important because
the health care environment is very matrixed, and
it's a team based sport. And the more
knowledge that a a physician leader can have
in those areas, the more equipped they're gonna
be able to have a a real conversation
when they're at the table talking about strategy,
for example.
So that CMO
role really should be a true business strategic,
you know, partner
as decisions are are being made.
And aspiring CMOs should be equipped to to
be part of that conversation.
The other part of what I think is
important that I mentioned before for aspiring CMOs
is really to make sure you are spending
time at the frontline to make sure you
are going to the hospital
unit, having conversations
directly with patients, having conversations directly with nurses.
And whether it's in the hospital or whether
it's in medical office practice or ambulatory surgery
centers, it's really important for a physician leader
to to be there, to see, to hear
directly from the front line so that the
person can really understand more deeply what's going
on and how they can be
helped and and really bring solutions,
to those
environments.
The the last thing I I wanted to
mention is is, you know, having
a comfort level, you know, with a matrix
type environment. You know, a physician leader
will be an influencer.
And the more that physician leader can have
an understanding of the different aspects of health
care, the more likely they're gonna be an
effective influencer
as decisions are being made about strategy,
in a health system environment.
Mhmm. I would love to hear more about,
kind of the influencer role, but we are
at time. Thank you so much, Andy, for
joining me on the podcast today and sharing
your sharp insights with us. For our audience
listening today, you can catch more of him
in our upcoming clinical leadership forum at the
Becker CEO and CFO roundtable,
which is taking place this November in Chicago.
We have limited space available for attendees and
sponsors, so contact us if you wanna snag
a spot. Thank you again, Andy. I really
appreciate it.
Thank you very much.