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Imagine this. You're at the Hyatt Regency Chicago

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immersed in insightful discussions with the health care

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industry's top leaders.

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Welcome to Becker's 12th annual CEO

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and CFO roundtable from November 11th to 14th

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2024.

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Picture yourself networking with over a 1000 executive

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level attendees,

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collecting business cards, and forging valuable connections.

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Feel the excitement as you engage in 4

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days of sessions featuring 400

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elite health system speakers.

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Envision yourself diving deep into critical topics like

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rural health care, digital transformation,

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health equity, and c suite diversity.

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Now imagine being inspired by our celebrity keynotes,

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pro football hall of famers Troy Aikman and

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Emmett Smith, 43rd president George w Bush, and

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author and journalist Jenna Bush Hager. Their stories

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will leave you motivated

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and energized.

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Don't miss this unparalleled

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opportunity.

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Get registered today. Visit beckershospitalreview.com

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and click on the events page to find

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the conference website.

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That's the beckershospitalreview.com

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events page. See you in Chicago.

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Hi. Welcome to the Becker's Healthcare podcast.

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My name is Paige Twenter. I'm an assistant

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editor here at Becker's Healthcare.

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I'm thrilled to interview Andy today.

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Thank you so much for joining me. Before

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we dive in, I'd love to have you

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introduce yourself and tell us about your background.

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Sounds great. Thank you.

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I am, Andy Anderson. I'm a a physician.

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I'm a general

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internist,

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by training, and I've worked as a a

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hospitalist

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and

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continue to do work as a primary care

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physician. And

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I am the chief medical officer and chief

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quality

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officer for RWJBarnabas

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Health,

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in New Jersey,

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which is a a health system with,

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12 adult hospitals and about $7,000,000,000

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in in revenue. And and my my role

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here is is essentially

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heavily focused on quality, safety, and

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patient experience,

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and also

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have oversight of our academic partnership with,

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Rutgers with regards to our training programs for

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future,

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health care professionals, including physicians in in our

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research infrastructure.

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So excited to to speak with you today.

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Yeah. Yeah. Same. Can you tell the audience,

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you know, a bit about

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in the past, you know, 6 months to

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last year, what has been the most successful

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project or initiative? You know, what what was

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it and what were the results?

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Yeah. We've we've been very focused on providing

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the the best

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outcomes for for our patients and and for

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our communities and and working on

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our patient experience

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and also on mortality. So I'll focus on

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mortality,

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which of course is

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very important

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and we've worked on

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the outcome side with regards to,

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preventing patients from from dying,

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but also on the documentation side to make

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sure we're accurately

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capturing

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how sick patients are so that their electronic

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health record is is up to date

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and more easily communicated,

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you know, across the health care team. We've

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seen a significant

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result. We've reduced our mortality

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by over 20% over the past couple of

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years by really focusing on

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a few things.

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One of them is is sepsis. Sepsis is

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the

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the infection

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situation that results in death, and about a

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third of our deaths are are related to

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that. And so making sure that we're recognizing

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sepsis

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as soon as possible

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and then intervening,

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you know, as soon as possible.

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One of the opportunities there has been our

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electronic health record, which is Epic, which has

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an alert system, which in turn goes to

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our rapid response team who is able to

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act quickly

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and intervene appropriately with things like antibiotics and

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and fluids.

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We also have,

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AI tool called the deterioration index embedded in

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EPIC, which predicts for us if someone's likely

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to die.

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And that tool, in turn, also provides the

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opportunity for our rapid response team and our

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floor teams to truly go and assess the

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patient real time and intervene real time so

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that we can make sure someone doesn't get

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sicker and make sure they are getting the

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care that they need,

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right away. So a lot of good work

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on our alert system,

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a lot of good work on making sure

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that we are rescuing patients who are getting

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sicker, a lot of good work on making

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sure that our patients are giving evidence based

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care and and best practice guidelines to make

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sure they get to the best outcomes.

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Yeah. 20%

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drop is pretty significant. Was it only sepsis,

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or were there other

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conditions you all were focusing on?

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Yes. It was across the board, in terms

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of the the 20%. Sepsis was a a

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big area of focus. We also spent

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a lot of time working on, the mortality

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review process. When someone does,

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die, we're able to really go back and

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see are there things we can learn from

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this, and then in turn, share that back

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to the team that was caring for the

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patient as well as share it as a

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system learning

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so that that others can can also learn

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from it in in the future.

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We've also done a lot of work on

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our ICUs in terms of our ventilator management,

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making sure that we are extubating patients timely,

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making sure that we're

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doing things like raising the head of the

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bed, making sure that we're providing really the

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best possible care for patients who who are

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already sick to make sure that they have

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the best chance of getting better.

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And with $7,000,000,000

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revenue and 12 hospitals,

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how do you,

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really ensure excellence, like and

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focus on, you know, these kind of wide

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scaling big hairy goals?

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Yeah. Part of it is is articulating

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the why, you know, why this is important

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and and really engaging

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our leaders and our frontline

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caregivers

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in the work and making sure that we're

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all doing the right thing, that we're following

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those those best practices. And, you know, part

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of our success I attribute to a team

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based

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approach, and we purposely

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had our chief medical officers, which are our

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doctor leaders, our chief nursing officers, our nurse

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leaders, as well as our our quality

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leaders really partnering

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together.

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They're at the table together. They're making sure

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that they are identifying

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those best practices, those pathways that are gonna

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provide the best outcomes for patients.

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And then making sure that we're all doing

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it and and really sharing results and trying

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to lift each other up. If one hospital

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is doing better in a certain area, we

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make sure that hospital shares what they're doing.

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Another hospital is is not doing well, then

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we have that hospital talk about their challenges

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and we we problem solve together. So really

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working together, sharing best practices, and truly operating

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as an integrated health system is making an

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enormous difference for us.

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On the vein of sharing best practices and,

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you know, problem solving when challenges arise,

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whether it's with the recent efforts of, reducing

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mortality

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or,

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you know, something else with their recent challenge

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that

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r j w RWJBarnabas

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recently overcame?

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Yeah. I think

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the the opportunity for us is is really

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to reengage

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our doctors and and our nurses and our

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our health care professionals.

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There was a lot of stress,

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from from COVID,

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from the financial challenges that all health systems

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had as we were coming out of COVID.

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There's there's just a lot going on in

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in health care, a lot of change, and

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so that that intensity,

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has caused some of our clinicians to to

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burn out. And and so we have a

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lot of focus on on wellness

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and making sure that we're supporting

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our doctors and our nurses and and all

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of our staff for that matter, in their

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work. Part of that goes back

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to having them feel the why, why this

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is important, you know, why they come to

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work, and that's very engaging. Part of it

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is trying to make sure that we're making

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it easier

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for everybody to to do their work. Part

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of that is the electronic health record and

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and making sure

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that the EMR is is easier to use

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for our clinicians.

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Part of it is just making sure that

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we are supporting each other,

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recognizing each other, and thanking each other, you

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know, appreciating

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the team that's doing work, you know, makes

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a huge difference. So

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really reengaging,

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and ultimately activating, you know, getting our clinicians

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and our staff excited about the work they're

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doing. That's what we're after and part of

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that is measured through our annual engagement survey

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and we saw a big jump in those

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results last year, which is is really important

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for us because it really takes a fully

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engaged workforce to be able to deliver

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the best possible outcomes.

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Are you thinking of recent example of addressing

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that burnout and forcing the why or reengaging

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your nurses and physicians? Was there

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something in particular you had in mind?

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Yeah. We've established we call them, wellness

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committees.

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Each of our

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hospitals,

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established

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a a group,

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that would be a a opportunity to listen

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to issues that come up,

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in in the hospital. Some of them are

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little things, simple things that can be

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easily fixed. Some of them are are more

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complicated,

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but having that that forum,

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to to share,

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challenges and to share stresses

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and then and working the list and trying

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to fix problems,

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as best we can. The other,

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tool that I find very powerful is we

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call it senior leader rounds,

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where the hospital c suite, you know, goes

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out to the hospital floors,

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meets with the staff, listens

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to any issues or concerns they have. Sometimes

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it's things like the supply chain function

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is not correctly working. You know, there's certain

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tools that that are not in place that

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need to be there.

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And some of those things can be fixed

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real time, which is very powerful to to

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see your c suite, you know, fixing your

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problem when you're a staff member on a

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on a floor unit.

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So that's been another great tool for us

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to help problem solve and and to help

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make the work environment easier for everybody.

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Mhmm. Yeah. I can only mention how encouraging

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it is to be, like, that real time

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fix. Like, as soon as the problem is

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raised, you know, and not waiting and emails

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and weeks weeks for something to be over

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with.

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We have a few minutes left. I wanna

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make sure I get to a few other

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questions. So I'm gonna give you 2 questions

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at once. One is, you know, how do

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you see the chief medical and quality officer

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roles evolving? And then also,

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to tack on what would be your advice

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for future aspiring,

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chief medical and quality officers?

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Yeah. The the chief medical officer role,

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I think will evolve to be

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more of a strategic,

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you know, business partner

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as a c suite member

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within a hospital or within a health system

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where the chief medical officer,

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who is really the physician leader,

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gets more involved in in all aspects of

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decision making. You know, the physician

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leader needs to understand the business, and and

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part of that is is my advice to

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aspiring

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CMOs is to understand the entirety of the

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health care business.

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Not that someone's gonna become a full subject

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matter expert in the finances of health care

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or, you know, how human resources,

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should work in a health system, but

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having deeper knowledge and experience and exposure

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to those different

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functions is very important because

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the health care environment is very matrixed, and

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it's a team based sport. And the more

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knowledge that a a physician leader can have

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in those areas, the more equipped they're gonna

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be able to have a a real conversation

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when they're at the table talking about strategy,

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for example.

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So that CMO

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role really should be a true business strategic,

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you know, partner

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as decisions are are being made.

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And aspiring CMOs should be equipped to to

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be part of that conversation.

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The other part of what I think is

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important that I mentioned before for aspiring CMOs

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is really to make sure you are spending

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time at the frontline to make sure you

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are going to the hospital

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unit, having conversations

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directly with patients, having conversations directly with nurses.

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And whether it's in the hospital or whether

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it's in medical office practice or ambulatory surgery

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centers, it's really important for a physician leader

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to to be there, to see, to hear

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directly from the front line so that the

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person can really understand more deeply what's going

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on and how they can be

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helped and and really bring solutions,

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to those

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environments.

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The the last thing I I wanted to

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mention is is, you know, having

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a comfort level, you know, with a matrix

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type environment. You know, a physician leader

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will be an influencer.

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And the more that physician leader can have

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an understanding of the different aspects of health

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care, the more likely they're gonna be an

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effective influencer

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as decisions are being made about strategy,

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in a health system environment.

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Mhmm. I would love to hear more about,

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kind of the influencer role, but we are

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at time. Thank you so much, Andy, for

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joining me on the podcast today and sharing

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your sharp insights with us. For our audience

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listening today, you can catch more of him

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in our upcoming clinical leadership forum at the

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Becker CEO and CFO roundtable,

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which is taking place this November in Chicago.

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We have limited space available for attendees and

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sponsors, so contact us if you wanna snag

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a spot. Thank you again, Andy. I really

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appreciate it.

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Thank you very much.