Hi, everyone. Thank you so much for tuning
in to the Becker's Health Care podcast.
I'm Erica Carbajal, an editor with Becker's Hospital
Review. And I'm so honored today to be
joined by doctor Marjorie Bessel, who is the
chief clinical officer at Banner Health. Doctor Bessel,
thank you so much for taking the time
to be on today.
It's my pleasure. Thank you for having me.
Yeah. A lots to talk about today. Lots
going on.
Before we get into it, do you mind
just sharing a little bit about the scope
of your work at Banner Health and how
long you've been there?
Absolutely. So,
I'm chief clinical officer for Banner Health and
have responsibility
for quite a number of activities within the
organization, but, of course, first and foremost is
the quality and safety of the care that
we deliver.
I also oversee a number of other areas,
including security,
performance improvement,
deep connection to our health plan through our
chief medical officers,
and enjoy every moment of my work.
I've been with Banner,
in my current role now, for eighteen years
with the organization and seven in my current
role, and it has been just a wonderful
organization to have a career of a lifetime
with.
Oh, eighteen years. Congrats on that, doctor Fussell.
Well, I'll get right into it. I know
Banner Health has achieved
impressive results under your tenure.
One of more recent ones, significant reductions in
length of stay, which is a huge,
area of focus for many health systems that
that led to nearly 28,000,000
in savings in 2023.
So can you take us behind these wins
and shed some light on on any key
strategies,
cultural shifts that helped drive the success, and
any lessons that other systems
might take away to drive similar improvements as
they really hone in on length of stay?
Absolutely, Erica. And thank you so much for
that. So first of all, kudos to our
team,
that worked together to deliver those results. We
have impressive results for 2024
also that we're still tabulating, but,
exceeded our goals on length of stay.
But as many of our listeners probably know,
length of stay is really a very significant
roll up measure
about everything that you do, how your entire
organization is functioning.
It includes everything from, like, your prehospital care,
the ED, which remains the front door to
most all of our hospitals,
the in hospital care and coordination, and then,
of course, providing with the needs of the
patient in the post discharge
arenas, whether that is going home with services,
going home without services, or needing to go
to another level of care for post discharge.
As you'll hear probably from myself, a number
of times here today and any of the
rest of us who are executives at Banner
Health, we have a very significant strategic approach
to everything, which is a one team approach.
As length of stay, that includes engaging everybody
across all those different areas that we spoke
about and doing work in all of those
areas. It takes a lot to move this
boulder of length of stay, and there is
a tipping point where you've got a lot
of items finally moving in a direction to
really start to see that length of stay
drop.
I love length of stay because it's a
coming together
of clinic
and operations
with a single focus of taking great care
of patients when we take great care of
patients and we don't have safety events. And
the quality of the care that we deliver
is really awesome, and we do a lot
of coordination,
that is when you see great length of
stay. It's great for the organization. It allows
us to have that bed open up to
take care of another patient who needs us
in our community.
It's also great for the patient right in
front of you who goes home on the
day that they expected
with a care plan that has been
executed and delivered to them and their their
caregiving team in a way that they expected.
So my
tip for, I guess, everybody out there is
to avoid looking for, like, the single lever
to improve this very roll up measure. Make
sure you're engaging with everybody like we do
with a one team approach,
nursing, your post acute providers that you probably
do not own and work collaboratively will with
your primary care physicians, your specialists,
and even those responsible for turnaround time of
your beds, think EVS.
They all play a big role as do
the hospitalists that are delivering the care each
and every day.
Yeah. Doctor Bessel, such great points just throughout
how,
you know, it really entails a strategic approach
across all those areas and teams, you know,
not just the front end, not just the
care coordination, not just one initiative, but really,
working in tandem to drive those ex improvements
and excited to hear more about the advancements
that that you mentioned for 2024
that are coming
through.
Doctor Bessel, on this,
you know, same topic, just kind of around
improving access and capacity,
it really is something that in almost every
conversation we have with health system leaders today
that comes up as an area of focus.
But at the same time, many acknowledge that
the cost of funding new efforts, whether that
be for certain technology or capital,
investments, expansions,
can be a barrier or challenge to improve
throughput.
So can you share a little bit about
this? How is Banner tackling
these challenges in the year ahead, and where
is the health system really focusing resources to
try to balance
cost and impact with capacity?
You know, Erica, thank you for asking that
question. It's such an important one, and I
know that for our listeners, it's one that
everybody is thinking about working on and very
focused on.
From a Banner Health perspective, again, I wanna
bring that strategic pillar in of the one
team approach to this.
Again, this is something that requires many of
our different parts of our organization coming together
and working together in order to move the
dial on this.
Another thing I'd like to call attention to
that's for our organization is that our mission
statement
is very consumer focused.
Making health care easier so life can be
better.
We know that health care made easier
is a tough calling and access is a
big piece of that. So here at Banner
Health, through our one team approach, we are
making investments in technology
that signify a commitment to our mission.
So that means both for patients and for
clinicians.
Making health care easier for our clinicians to
deliver so that their professional
life and journey and career can be better
with us here at Banner Health.
A big piece of this is how can
we help reduce the burden of what it
takes for a clinician to deliver care. So
investments in AI technology, specifically around ambient listening,
is a big one for clinicians.
One of my absolute deliverables in the next
five years is to reduce the administrative
burden for clinicians by 50%.
That is a huge audacious goal, and yet
I feel that when you have me back
in five years, I'm gonna tell you that
we got it done together here at Banner
Health. And it's gonna be through these AI
and technology investments
that make the day and the life of
the clinician better, helps make them more efficient
so that access is opened up to those
patients that need need us. As I think
we're all discovering,
AI technology has a lot of different flavors
out there, but when you're really focused on
trying to reduce that administrative burden,
it not only helps the clinician, but it
enables a better visit for the patient.
There's of course more efficiency for the physicians
and and every other provider and that then
of course opens up access for patients. So
more to come on that, like many of
us, in the industry, we're relatively still learning
about ambient listening and these
other technologies to deliver everything that I spoke
about, but it's moving really quickly. And I
think we will all see really significant deliverables
that happen and get all the way across
the finish line in 2025.
Yeah. Some huge goals there, that 50%. It's
so interesting. Do you have that broken down?
I know you said over five years. You
have that broken down sort of into,
you know, more tangible goals year by year.
Is that sort of how do you've organized
that one?
So, you know, the interesting thing about that
big audacious goal is we don't know exactly
how we're gonna get there yet, but we
do have some really tangible goals as technology
becomes available.
I firmly believe that as we, you know,
just spoke about a little bit ago, that
ambient listening is a huge piece of that
50% burden, and that field is changing really
quickly.
I expect that within the next eighteen months,
every single one of our physicians here at
Banner Health will have an ambient listening tool
that is really fine tuned for their specialty
and the way they deliver care at their
fingertips and being really utilized that will open
up that access for patients to get to
in to see them more quickly.
Yeah. For sure. So much,
optimism around these tools. I I was speaking
with another leader recently, physician leader who who,
you know, said hesitant to call things game
changers in health care and and use that
term sparsely, but, really,
no hesitation
when it comes to using that to describe
ambient listening and just based on what physicians
are saying through pilots and saying, you know,
we really can't imagine going back to not
having this. So,
sort of the cat is out of the
bag there. It it's just so interesting to
hear
how big of a role it really plays
in freeing them up and then that that
how that translates into,
additional capacity and freeing things up.
I completely agree, and I think game changer.
I will commit to that term for this
one.
Our pilots are exactly as you described, and
you know that you've had a game changer
when people are begging you to not take
the tool away.
Yeah. Absolutely.
Doctor Bessel, I wanted to ask you as
well just about something that comes up frequently,
a challenge in conversations with physician executives,
and that is just around engaging younger health
care workers in leadership.
Is that something that resonates with you? And
if so, what has been effective in encouraging
people to explore their own leadership potential and
not shy away from it off the bat.
Another really awesome and important topic. So, certainly,
preparing future decades of the workforce is a
very important aspect
for anybody who's an executive in health care
right now. Here at Banner Health, we are
really deeply embedded in our communities, and we
have a number of strategies that we work
with to make sure that young students, first
of all, are going to enter in health
care. And then, of course, once they're in
health care, it's very important to show all
of our team members how there is a
journey of a lifetime available for them with
us So that, of course, includes physician leadership
Here at Banner, we've built a really nice
portfolio of offerings to develop skills for these
types of individuals
As we all know, skills like these are
valuable in many other parts of our life
It helps us be better with our families,
it helps us
families. It helps us be better with our
patients and our day to day clinical teams.
I've been lucky because I've been here, in
developing these for over ten years now. And
I think it's really important
for physicians to see that they don't always
get these skills in their formalized training. And
here at Banner and other organizations, we recognize
that we need to really engage with them
to help them work on them.
Here at Banner Health, it culminates with a
course that we call ALP, which is advanced
leadership course for physicians in APP.
And I'm happy to say that we just
graduated our eighteenth cohort
of that. I think what we hear most
about those that have finished this is the
personal stories
that resonate
with them from leaders in our organization.
Many of us, myself included,
don't start with a really crisp road map
of, hey. I'm starting as a bedside clinician,
and I wanna be x. Chief clinical officer,
chief medical officer, physician executive, you fill in
the role.
So it's really important that we capitalize on
those stories and let people know, hey. You're
going to be on a journey.
You need to work with others, and you
need to trust others who see potential in
you and ask you to do things like
take on a new project and say yes
to that. Again, kinda Erica, going back to
our one team approach here at Banner Health,
I think that has been a secret sauce
of success.
Our guest speakers at these programs, of course,
they're not just physicians. They're executives from across
our large organization,
and I think that helps show everyone how
we're really committed to that collaboration for the
development of those physician leaders.
Yeah. That's great. What a great program.
Great to hear that eighteenth cohort has gone
through that and is finding value in that.
Doctor Bessel, on the topic too of physician
workforce shortages,
obviously, a huge area of coverage and a
major concern across health care.
What do you think is missing from conversations
about this issue? Are there any overlooked factors,
perspectives that you call out, that health systems
might be
or should be paying more attention to?
So I I'm not sure that there are
things that are per se, you know, overlooked.
Again, I think these shortages are complex. They're
multi pronged and therefore need a very multidisciplinary
approach.
I'll highlight a couple things that are very
important here at Banner Health that may resonate
with some of our leaders. So first of
all,
Banner Health is coming up on our ten
year anniversary of our relationship with the University
of Arizona,
which is the state's largest academic medicine program.
A big statistic that we're very proud of
is that we train more than 1,300 residents
and fellows and 5,000 nurses rotate through Banner
every
year. This relationship with our academic partner is
a big piece and a huge important part
of trying to address those workforce shortages of
the future and really working together to support
our communities so that we're there for them
and can provide care.
Another piece I'd like to talk about is
the promotion of well-being.
We know that well-being and the reduction of
burnout is an important piece of addressing workforce
shortages.
We've all seen the aftereffect of the stress
and strain of the pandemic
and what that did to our workforce.
We've been very committed to that work across
our organization,
have been
really exquisite about measuring our impact, and I'm
happy to report had great success in 2024
with the lowest rate of self reported burnout
since we started exquisitely measuring that in 2018.
Another piece of that, like we already talked
about, Erica, is making sure that you're investing
in technology and the right technology
that can help make your workforce very efficient.
And lastly, do you wanna talk about making
sure that you have your physicians and your
clinicians
at the table for decision making.
I think we all have recognized
the stress and strain of being in the
industry and how that really gets accentuated
when physicians and other clinicians feel like they
don't have a voice at the table where
decisions are being made, where they feel like
they lose their autonomy.
And that, of course, leads to a lot
of potential
departures and general disgruntlement about being in the
industry.
As we spoke about technology, ambient listening is
a big piece of that and constantly looking,
and my five year goal of reducing that
administrative burden, I think, needs to be at
the forefront for all of us. That will
help us mitigate
these workforce shortages in the future by making
sure that we're making our workforce as engaged,
as productive,
and as happy as possible
at work each and every day.
Oh, yeah. The
great success with,
lowering that self reported burnout rate. I think
it's such a big win,
because I know we've seen some of the
national numbers, and trends haven't moved too too
much, you know, from 2021, '20 '20 '2,
etcetera. So,
just great to to hear about that and
just all the ways that those technology investments
and that really unburdening
physicians and focus there is showing results and
and having a strong impact.
Doctor Bessel, to close us out, can you
share a piece of advice for emerging clinical
executives in health care? Is there a memorable
piece of advice you've received at some point
in your career that's helped shape your leadership
style that still shows up today?
Yeah. Such a great question and what a
great one, to close out.
So my best piece of advice that I
would give to others and one that was
offered to me really early in my career
that I think was incredibly helpful
was making sure that you are open to
trying different experiences.
Simple to say, hard to do.
But what comes along with that is that
when you really listen to others, when they
perhaps give you an opportunity,
sometimes we don't even recognize that it's an
opportunity.
So something like, hey, do you mind standing
in for me at this meeting? Do you
mind taking on this short project that has
two meetings?
It can be something as small as that.
But I think saying yes to those experiences
is so incredibly helpful for growth. And what
sits behind that, which I think is a
really important takeaway from this conversation,
is that the person
asking you to potentially do something different as
an experience
is seeing something in you that perhaps you
don't recognize yourself.
So when somebody asks you to do that
extra
thing, try and think of it as both
a yes as well as, like,
that person must see something in me. Let
me find out more about that. Go do
this project and do a follow-up to find
out what else I can work on for
my future.
It was really helpful for me in my
career, and I hope it's helpful for our
listeners.
Yeah. What a great way to close out.
Doctor Bessel, thank you so much. It's been
a pleasure having you on today, and I'm
sure
listeners will just find this conversation
so valuable. We talked about so many big
pressing trends affecting health care operations,
from patient throughput, physician satisfaction, etcetera. So so
appreciate your insights.
So wonderful to be with you, and I
hope our listeners enjoy
our conversation as well.
For sure. Look forward to connecting again.