1 00:00:00,480 --> 00:00:03,199 Hello everyone and welcome to the Becker's Healthcare 2 00:00:03,199 --> 00:00:03,699 Podcast. 3 00:00:04,319 --> 00:00:07,519 I'm Mackenzie Bean, associate vice president and managing 4 00:00:07,519 --> 00:00:09,859 editor of Becker's Hospital Review. 5 00:00:10,400 --> 00:00:12,400 Today I'm so thrilled to be joined by 6 00:00:12,400 --> 00:00:13,939 Doctor. Geraldo Xavier, 7 00:00:14,525 --> 00:00:17,904 chief medical officer of Atlantic Health Systems, Hackettstown 8 00:00:18,045 --> 00:00:19,504 and Newton Medical Centers. 9 00:00:19,964 --> 00:00:22,204 Doctor Xavier, thank you for joining us today. 10 00:00:22,204 --> 00:00:23,184 How are you doing? 11 00:00:23,724 --> 00:00:26,204 I am doing really well, Mackenzie. Thank you 12 00:00:26,204 --> 00:00:27,644 so much for having me. I am, 13 00:00:28,500 --> 00:00:30,440 appreciate the opportunity to participate, 14 00:00:31,460 --> 00:00:33,539 in the podcast and really looking forward to 15 00:00:33,539 --> 00:00:34,200 the conversation. 16 00:00:34,899 --> 00:00:37,060 Well, I'm looking forward to it just as 17 00:00:37,060 --> 00:00:37,560 much. 18 00:00:38,179 --> 00:00:39,719 I know I was reading, 19 00:00:40,100 --> 00:00:40,840 your bio, 20 00:00:41,460 --> 00:00:42,765 just before this, and 21 00:00:43,164 --> 00:00:44,204 it it had a line that I really 22 00:00:44,204 --> 00:00:46,765 loved, which is you have a strong reputation 23 00:00:46,765 --> 00:00:48,684 for being a change management champion. And I 24 00:00:48,684 --> 00:00:50,765 feel like that's probably gonna shine through today, 25 00:00:50,765 --> 00:00:51,984 so I'm excited to, 26 00:00:52,604 --> 00:00:54,045 learn more about that and some of the 27 00:00:54,045 --> 00:00:56,630 work you're doing at Atlantic Health. But before 28 00:00:56,630 --> 00:00:57,929 we dive into that specifically, 29 00:00:58,390 --> 00:00:59,829 can you just share a little bit more 30 00:00:59,829 --> 00:01:01,450 about yourself and your background? 31 00:01:02,630 --> 00:01:03,130 Absolutely. 32 00:01:04,069 --> 00:01:06,549 So yeah. You know, I was reflecting on, 33 00:01:07,510 --> 00:01:09,430 what we're gonna talk about today, and I 34 00:01:09,430 --> 00:01:10,329 thought to myself, 35 00:01:11,245 --> 00:01:13,265 Jesus. I am a board certified 36 00:01:13,564 --> 00:01:16,765 practicing emergency physician for now over twenty years, 37 00:01:16,765 --> 00:01:19,424 and I thought Amazing. Time does fly. 38 00:01:20,685 --> 00:01:22,864 But, yeah, I I completed my education 39 00:01:23,244 --> 00:01:23,744 at 40 00:01:24,760 --> 00:01:28,040 UMDNJ Robert Wood Johnson University Medical School, which 41 00:01:28,040 --> 00:01:30,920 is now actually renamed Rutgers Robert Wood Johnson 42 00:01:30,920 --> 00:01:33,420 Medical School where I got a dual degree. 43 00:01:33,719 --> 00:01:35,959 I did a medical degree as well as 44 00:01:35,959 --> 00:01:37,420 a master's in public health. 45 00:01:37,805 --> 00:01:40,924 I then completed my emergency medicine residency training 46 00:01:40,924 --> 00:01:41,984 in New York City, 47 00:01:42,444 --> 00:01:43,584 my home state, 48 00:01:44,284 --> 00:01:47,484 and, at the previously Columbia affiliated St. Luke's 49 00:01:47,484 --> 00:01:49,424 Roosevelt Hospital System, which 50 00:01:49,819 --> 00:01:51,739 has now also been renamed and is now 51 00:01:51,739 --> 00:01:54,700 within the Mount Sinai family, and it's, Mount 52 00:01:54,700 --> 00:01:55,200 Sinai 53 00:01:55,579 --> 00:01:57,920 Morton Side and Mount Sinai West. 54 00:01:58,939 --> 00:02:01,420 From there, I've I've had several years of 55 00:02:01,420 --> 00:02:01,920 practice. 56 00:02:02,515 --> 00:02:04,395 I went back to school and got my 57 00:02:04,395 --> 00:02:05,855 master's in business administration 58 00:02:06,635 --> 00:02:09,194 from Haslam College of Business at the University 59 00:02:09,194 --> 00:02:09,935 of Tennessee, 60 00:02:10,634 --> 00:02:11,375 in Knoxville. 61 00:02:12,715 --> 00:02:15,594 Along my educational journey, I also completed a 62 00:02:15,594 --> 00:02:18,689 safety quality informatics and leadership program at Harvard 63 00:02:18,689 --> 00:02:19,670 School of Medicine 64 00:02:20,290 --> 00:02:21,750 and the adviser program 65 00:02:22,210 --> 00:02:24,770 at IHI, which is the Institute for Healthcare 66 00:02:24,770 --> 00:02:25,270 Improvement. 67 00:02:26,129 --> 00:02:28,129 Here is where you'll see a lot of 68 00:02:28,129 --> 00:02:29,909 the training around change management, 69 00:02:30,370 --> 00:02:32,290 that we'll talk about in terms of how 70 00:02:32,290 --> 00:02:32,790 I, 71 00:02:33,584 --> 00:02:35,284 incorporate that to do work, 72 00:02:35,745 --> 00:02:38,164 at my facilities, and I'm also a certified 73 00:02:38,705 --> 00:02:40,245 Lean Greenbelt Six Sigma. 74 00:02:41,264 --> 00:02:43,745 So over the two decades, in addition to 75 00:02:43,745 --> 00:02:47,284 clinical practice, I've had several leadership roles including 76 00:02:47,344 --> 00:02:48,405 department chair, 77 00:02:48,710 --> 00:02:49,530 chief quality officer 78 00:02:50,469 --> 00:02:51,450 at both community, 79 00:02:52,150 --> 00:02:55,290 hospitals and large level one trauma academic centers 80 00:02:55,909 --> 00:02:57,050 leading multidisciplinary 81 00:02:57,669 --> 00:02:58,889 cross functional teams. 82 00:02:59,510 --> 00:03:01,590 As you stated in my current role at 83 00:03:01,590 --> 00:03:03,944 Atlantic Health System, I serve as the chief 84 00:03:04,185 --> 00:03:05,645 medical officer over 85 00:03:06,025 --> 00:03:08,925 two of our, hospitals in the Western Region, 86 00:03:09,545 --> 00:03:11,724 Hackettstown and Newton Medical Center. 87 00:03:12,504 --> 00:03:14,125 And currently, some of my responsibilities, 88 00:03:15,385 --> 00:03:17,004 include leadership oversight 89 00:03:17,305 --> 00:03:19,500 of clinical operation, including care 90 00:03:20,460 --> 00:03:20,960 coordination, 91 00:03:21,500 --> 00:03:23,599 quality and patient safety initiatives, 92 00:03:24,780 --> 00:03:27,340 obviously, our med staff functions and working to 93 00:03:27,340 --> 00:03:27,840 ensure 94 00:03:28,460 --> 00:03:30,460 we strengthen the relationship and, 95 00:03:30,780 --> 00:03:31,180 and, 96 00:03:31,740 --> 00:03:33,580 engagement and alignment with the or from the 97 00:03:33,659 --> 00:03:34,479 with the organization 98 00:03:35,314 --> 00:03:36,854 and the med staff, which 99 00:03:37,235 --> 00:03:39,634 I have the privilege of working with both 100 00:03:39,634 --> 00:03:40,134 employed, 101 00:03:40,675 --> 00:03:41,175 physicians 102 00:03:41,875 --> 00:03:44,694 and allied head workers as well as private, 103 00:03:45,314 --> 00:03:47,175 physicians and allied head professionals. 104 00:03:48,500 --> 00:03:50,819 I also served as a cochair of our 105 00:03:50,819 --> 00:03:52,919 Atlantic Health System women leadership 106 00:03:53,540 --> 00:03:55,000 business resource group. 107 00:03:55,379 --> 00:03:57,300 I really continue to serve as a mentor 108 00:03:57,300 --> 00:03:59,879 to many of our emerging leaders both within 109 00:04:00,419 --> 00:04:01,159 the organization 110 00:04:01,540 --> 00:04:02,280 and outside. 111 00:04:03,474 --> 00:04:04,854 I thought about, wow. 112 00:04:05,555 --> 00:04:08,854 That's a lot of documented accomplishment around education 113 00:04:09,155 --> 00:04:10,995 and work, but maybe I should share a 114 00:04:10,995 --> 00:04:12,775 little bit about me, which is 115 00:04:13,555 --> 00:04:16,115 I couldn't do any of this without my 116 00:04:16,435 --> 00:04:17,814 the support of my family. 117 00:04:18,889 --> 00:04:20,349 I've been really fortunate 118 00:04:20,729 --> 00:04:23,449 to have an extremely supportive spouse of twenty 119 00:04:23,449 --> 00:04:24,110 five years 120 00:04:24,649 --> 00:04:28,029 and three amazing kids who keep us busy 121 00:04:28,649 --> 00:04:29,469 and grounded, 122 00:04:30,490 --> 00:04:31,709 and really enjoy 123 00:04:32,595 --> 00:04:34,055 traveling with our family. 124 00:04:35,074 --> 00:04:35,735 Our last 125 00:04:36,275 --> 00:04:36,775 trip, 126 00:04:37,634 --> 00:04:40,035 we did was to South Africa, and that 127 00:04:40,035 --> 00:04:40,775 was really, 128 00:04:41,634 --> 00:04:43,475 eye opening in so many ways. I got 129 00:04:43,475 --> 00:04:44,134 the opportunity 130 00:04:44,675 --> 00:04:46,855 to visit Robben Island where 131 00:04:47,379 --> 00:04:49,000 Nelson Mandela and other political 132 00:04:49,459 --> 00:04:52,579 figures were held and just really sharing that 133 00:04:52,579 --> 00:04:54,040 history with our children, 134 00:04:55,139 --> 00:04:56,600 who are all school aged. 135 00:04:57,139 --> 00:04:59,139 And, of course, we you cannot go to 136 00:04:59,139 --> 00:05:02,074 South Africa without, going to the safari and 137 00:05:02,074 --> 00:05:03,535 experiencing the diverse, 138 00:05:04,795 --> 00:05:05,295 biodiversity 139 00:05:05,915 --> 00:05:08,235 of the, not just the culture, but of 140 00:05:08,235 --> 00:05:11,754 the environment. And, so that was really a 141 00:05:11,754 --> 00:05:14,175 fun thing to do with with my family. 142 00:05:14,750 --> 00:05:17,069 And then for me, balancing all of that, 143 00:05:17,069 --> 00:05:19,230 I enjoy being outdoors. So I'm a long 144 00:05:19,230 --> 00:05:20,129 distance runner, 145 00:05:20,670 --> 00:05:21,410 and so 146 00:05:21,790 --> 00:05:25,330 I love participating in short distances, five k's, 147 00:05:25,550 --> 00:05:27,009 as well as half marathons. 148 00:05:27,790 --> 00:05:29,410 So I that keeps me busy 149 00:05:29,884 --> 00:05:31,644 with the current lifestyle that I live. So, 150 00:05:31,644 --> 00:05:33,004 hopefully, that gives you a little bit of 151 00:05:33,004 --> 00:05:33,504 flavor 152 00:05:33,964 --> 00:05:36,444 as to who I am and what really 153 00:05:36,444 --> 00:05:38,384 drives me in terms of the 154 00:05:38,925 --> 00:05:39,985 the work that I do. 155 00:05:41,004 --> 00:05:41,504 Absolutely. 156 00:05:42,439 --> 00:05:46,039 Sounds like an extremely full life, full career, 157 00:05:46,039 --> 00:05:47,719 and I think that paints a great picture 158 00:05:47,719 --> 00:05:48,219 of, 159 00:05:48,839 --> 00:05:50,360 you know, the type of leader you are 160 00:05:50,360 --> 00:05:52,539 and the experiences that shape you. 161 00:05:53,000 --> 00:05:54,839 I'd love to hone in now on some 162 00:05:54,839 --> 00:05:56,599 of the work you're doing at Atlantic Health 163 00:05:56,599 --> 00:05:59,294 that you, I know, started to allude to. 164 00:05:59,294 --> 00:06:01,294 Can you tell us that maybe a a 165 00:06:01,294 --> 00:06:04,175 successful project or initiative that you're particularly proud 166 00:06:04,175 --> 00:06:06,495 of from the last year? What was it? 167 00:06:06,495 --> 00:06:08,115 What results did you see? 168 00:06:08,894 --> 00:06:10,735 Yeah. No. Thanks. That's a that's thanks for 169 00:06:10,735 --> 00:06:13,610 that question. That's really a major part of 170 00:06:13,610 --> 00:06:15,310 the work I do with any organization 171 00:06:15,610 --> 00:06:16,750 is around really 172 00:06:17,370 --> 00:06:19,949 aligning and organizing around our strategic, 173 00:06:21,610 --> 00:06:23,470 enterprise strategic objectives, 174 00:06:24,089 --> 00:06:25,629 which I am really, 175 00:06:26,009 --> 00:06:28,189 really fortunate to be part of an organization 176 00:06:28,545 --> 00:06:31,425 whose focus is demonstrating excellence at the highest 177 00:06:31,425 --> 00:06:32,485 national level, 178 00:06:33,105 --> 00:06:34,004 leading improvement 179 00:06:34,545 --> 00:06:37,125 around patient access, experience, and affordability. 180 00:06:38,064 --> 00:06:40,384 And so when we embark on initiatives, we 181 00:06:40,384 --> 00:06:41,444 really strategize 182 00:06:42,100 --> 00:06:45,240 our initiatives around our four main pillars. 183 00:06:45,540 --> 00:06:47,699 And just to share, our main pillars of 184 00:06:47,699 --> 00:06:49,399 how we do work is around performance, 185 00:06:49,939 --> 00:06:52,040 population health, growth and stability, 186 00:06:52,660 --> 00:06:54,360 innovation research, and education. 187 00:06:55,904 --> 00:06:56,805 So under those, 188 00:06:57,345 --> 00:06:58,964 four domain, we 189 00:07:00,384 --> 00:07:02,725 focus on the performance domain, 190 00:07:03,585 --> 00:07:05,845 that would align with our quality goals 191 00:07:06,305 --> 00:07:07,685 as one of our priorities, 192 00:07:07,985 --> 00:07:09,444 which was to reduce 193 00:07:09,850 --> 00:07:11,629 thirty day readmission rates 194 00:07:12,009 --> 00:07:15,470 on CMS hospital readmit reduction penalty program. 195 00:07:16,089 --> 00:07:18,269 This program includes principal diagnoses 196 00:07:18,730 --> 00:07:20,029 such as heart failure, 197 00:07:20,410 --> 00:07:22,430 chronic obstructive pulmonary disease, 198 00:07:22,730 --> 00:07:24,910 acute myocardial infarction, and pneumonia. 199 00:07:25,814 --> 00:07:28,375 In my region, we in reviewing the data, 200 00:07:28,375 --> 00:07:31,275 we saw opportunities to improve our outcomes 201 00:07:31,735 --> 00:07:35,194 by decreasing the readmission rates across these cohorts. 202 00:07:36,134 --> 00:07:38,795 So using data to guide our decisions, 203 00:07:39,589 --> 00:07:41,370 we put together a multidisciplinary 204 00:07:41,990 --> 00:07:43,930 team of key stakeholders 205 00:07:44,949 --> 00:07:45,449 including 206 00:07:45,830 --> 00:07:46,330 cardiologists, 207 00:07:47,110 --> 00:07:48,170 hospital medicine, 208 00:07:48,710 --> 00:07:49,210 pulmonologists, 209 00:07:49,910 --> 00:07:50,410 pharmacy, 210 00:07:50,790 --> 00:07:51,290 nursing, 211 00:07:51,910 --> 00:07:53,290 transitions of care, 212 00:07:54,134 --> 00:07:56,535 members that interacts with the patient and the 213 00:07:56,535 --> 00:07:58,154 community to name a few. 214 00:07:59,415 --> 00:08:01,514 We also embarked on using 215 00:08:01,814 --> 00:08:02,314 robust, 216 00:08:02,855 --> 00:08:05,274 performance improvement methodology and tools 217 00:08:05,654 --> 00:08:07,355 to create a charter establishing 218 00:08:07,735 --> 00:08:09,115 the process measures 219 00:08:09,790 --> 00:08:11,730 that we seek to improve 220 00:08:12,189 --> 00:08:14,509 the outcome measures and the balancing measures so 221 00:08:14,509 --> 00:08:15,410 that we know, 222 00:08:16,029 --> 00:08:17,170 what are the changes 223 00:08:17,790 --> 00:08:19,550 that we're gonna make that may lead to 224 00:08:19,550 --> 00:08:21,250 the improvement that we seek. 225 00:08:21,709 --> 00:08:22,209 Additionally, 226 00:08:22,509 --> 00:08:26,134 we work with frontline teams to streamline multiple 227 00:08:26,194 --> 00:08:26,694 workflows, 228 00:08:28,034 --> 00:08:29,654 creating education materials 229 00:08:30,115 --> 00:08:30,854 for both 230 00:08:32,195 --> 00:08:34,375 the team members as well as the patient, 231 00:08:34,995 --> 00:08:37,095 to ensure that we are providing 232 00:08:37,554 --> 00:08:40,200 the right amount of information and tools to 233 00:08:40,259 --> 00:08:41,320 our patient including, 234 00:08:42,580 --> 00:08:44,659 scales to make sure that they can weigh 235 00:08:44,659 --> 00:08:46,200 themselves at home, etcetera. 236 00:08:46,899 --> 00:08:50,100 We definitely collaborated with providers in the community 237 00:08:50,100 --> 00:08:52,659 as well to ensure that we could have 238 00:08:52,659 --> 00:08:55,495 a follow-up appointment scheduled for within one week 239 00:08:55,495 --> 00:08:57,815 of discharge. And as I had indicated in 240 00:08:57,815 --> 00:09:00,295 the past, in the community that I serve 241 00:09:00,295 --> 00:09:02,615 and I work with, we do have, again, 242 00:09:02,615 --> 00:09:06,375 employed physicians as well as independent practitioners of 243 00:09:06,375 --> 00:09:08,315 the medical staff. So it was totally 244 00:09:08,789 --> 00:09:10,009 being very inclusive, 245 00:09:10,789 --> 00:09:12,870 of the way that we do provide care 246 00:09:12,870 --> 00:09:14,870 for our patients in our community. And, of 247 00:09:14,870 --> 00:09:17,289 course, making sure that we utilize our transitions 248 00:09:17,350 --> 00:09:20,309 of care nurses to monitor the patients post 249 00:09:20,309 --> 00:09:20,809 discharge. 250 00:09:21,745 --> 00:09:23,184 Just really proud of. There's a lot of 251 00:09:23,184 --> 00:09:25,445 work that went into that over several months. 252 00:09:25,825 --> 00:09:28,304 We did celebrate the small wins as we 253 00:09:28,304 --> 00:09:30,404 move along the project milestones. 254 00:09:31,024 --> 00:09:33,684 And, really, at the end, we, we outperformed 255 00:09:33,985 --> 00:09:36,165 the expected targets in all the cohorts. 256 00:09:37,199 --> 00:09:39,120 Really proud to say that we took that 257 00:09:39,120 --> 00:09:40,579 work, some of that work, 258 00:09:41,039 --> 00:09:41,539 and, 259 00:09:42,319 --> 00:09:42,819 submitted, 260 00:09:43,759 --> 00:09:45,839 and it was and submitted the work, and 261 00:09:45,839 --> 00:09:48,639 that was accepted for poster presentation at the 262 00:09:48,639 --> 00:09:49,779 twenty twenty four 263 00:09:50,235 --> 00:09:53,274 International Healthcare Institute, which is for short IHI 264 00:09:53,274 --> 00:09:55,134 forum. So our team's 265 00:09:55,674 --> 00:09:58,095 part of the celebration was going to IHI, 266 00:09:59,195 --> 00:10:01,914 and presenting the work that we did and 267 00:10:01,914 --> 00:10:02,414 sharing, 268 00:10:03,034 --> 00:10:04,254 across the national's 269 00:10:04,709 --> 00:10:05,209 forum 270 00:10:05,589 --> 00:10:07,990 the things we did to see the improvements 271 00:10:07,990 --> 00:10:08,809 that we saw. 272 00:10:09,269 --> 00:10:11,509 Certainly, one of the challenges and I'm always 273 00:10:11,509 --> 00:10:13,669 looking at what are the lessons learned. And 274 00:10:13,669 --> 00:10:15,669 the lesson learned one of the lessons learned 275 00:10:15,669 --> 00:10:16,649 is really about 276 00:10:18,375 --> 00:10:21,034 what we find to be successful is really 277 00:10:21,334 --> 00:10:22,475 the really, 278 00:10:23,174 --> 00:10:26,074 intentional way we communicate it with the multidisciplinary 279 00:10:26,454 --> 00:10:26,954 team 280 00:10:27,334 --> 00:10:29,654 to share the reason for action. Why are 281 00:10:29,654 --> 00:10:32,070 we doing this? Why does it matter? How 282 00:10:32,070 --> 00:10:33,850 does it align with the organizational 283 00:10:34,230 --> 00:10:36,549 priority? And how does it align in how 284 00:10:36,549 --> 00:10:37,929 we care for our patients 285 00:10:38,309 --> 00:10:40,470 so that they can receive the best care 286 00:10:40,470 --> 00:10:42,009 and the best outcome possible, 287 00:10:42,549 --> 00:10:44,730 within our system? And in and 288 00:10:45,115 --> 00:10:47,434 when you talk about transition as well as 289 00:10:47,434 --> 00:10:48,894 when they're in their communities 290 00:10:49,434 --> 00:10:50,894 in the ambulatory setting. 291 00:10:51,274 --> 00:10:53,674 The other thing we learned is that there 292 00:10:53,674 --> 00:10:56,634 is sometimes challenges in follow ups of patients, 293 00:10:57,670 --> 00:10:59,750 because many of them may have some social 294 00:10:59,750 --> 00:11:02,250 determinants of health factors. So how do we 295 00:11:02,710 --> 00:11:05,769 bake around using the resources in the community 296 00:11:05,910 --> 00:11:07,370 to provide those, 297 00:11:08,950 --> 00:11:09,450 those 298 00:11:09,934 --> 00:11:12,174 patients with the things they need so that 299 00:11:12,174 --> 00:11:13,695 they could get the medicine, so that they 300 00:11:13,695 --> 00:11:15,955 can have transportation to go to the appointment 301 00:11:16,334 --> 00:11:18,034 as such for for those, 302 00:11:18,654 --> 00:11:20,834 what we call SDOH risk factors. 303 00:11:21,789 --> 00:11:24,110 So, yeah, that that that was really, it 304 00:11:24,110 --> 00:11:25,870 was a joy and and a pleasure, and 305 00:11:25,870 --> 00:11:26,850 we continue to, 306 00:11:27,549 --> 00:11:31,090 see sustained results even throughout this time where 307 00:11:31,309 --> 00:11:34,850 the teams are just monitoring all the intervention 308 00:11:35,070 --> 00:11:37,184 measures we put in place to ensure we 309 00:11:37,184 --> 00:11:37,924 stay on track. 310 00:11:39,105 --> 00:11:42,485 Wow. It sounds like extremely impressive results and 311 00:11:42,544 --> 00:11:44,225 how meaningful for the team to be able 312 00:11:44,225 --> 00:11:46,785 to present it at IHI and really share 313 00:11:46,785 --> 00:11:49,024 that as a national example for other systems 314 00:11:49,024 --> 00:11:50,544 to learn from as well. And I appreciate 315 00:11:50,544 --> 00:11:53,110 you outlining those lessons. It sounds like that 316 00:11:53,110 --> 00:11:54,250 intentional communication 317 00:11:54,870 --> 00:11:56,549 and really explaining the purpose and why it 318 00:11:56,549 --> 00:11:58,710 was, like, so crew so crucial to the 319 00:11:58,710 --> 00:11:59,610 program success. 320 00:12:00,790 --> 00:12:01,290 Absolutely. 321 00:12:01,669 --> 00:12:02,169 Absolutely. 322 00:12:02,950 --> 00:12:05,129 Well, let's look ahead maybe to the next 323 00:12:05,190 --> 00:12:05,690 year 324 00:12:06,884 --> 00:12:08,985 for the in the sake of constant improvement. 325 00:12:10,245 --> 00:12:12,404 What is the biggest challenge that you're thinking 326 00:12:12,404 --> 00:12:14,904 about right now, or is there another specific 327 00:12:14,964 --> 00:12:15,464 initiative, 328 00:12:15,845 --> 00:12:18,004 or project that you're working on in 2025 329 00:12:18,004 --> 00:12:19,144 that you'd like to know? 330 00:12:20,399 --> 00:12:21,679 For for us and 331 00:12:22,480 --> 00:12:23,700 clearly, as you know, 332 00:12:24,080 --> 00:12:24,720 health care, 333 00:12:25,120 --> 00:12:28,399 delivery is changing rapidly. It's constantly evolving. As 334 00:12:28,399 --> 00:12:30,720 a CMO, you're constantly you have to stay 335 00:12:30,720 --> 00:12:32,480 agile and really adjust to some of the 336 00:12:32,480 --> 00:12:34,934 changes. However, I would suggest to you one 337 00:12:34,934 --> 00:12:36,934 of our biggest challenge, and I'm sure it's 338 00:12:36,934 --> 00:12:39,495 a challenge for some organization, is really access 339 00:12:39,495 --> 00:12:40,235 to specialties. 340 00:12:40,934 --> 00:12:43,414 I think that we were not immune to 341 00:12:43,414 --> 00:12:45,894 the great resignation that we saw at the 342 00:12:45,894 --> 00:12:47,789 at the somewhat towards the end of the 343 00:12:47,789 --> 00:12:48,289 pandemic. 344 00:12:48,750 --> 00:12:51,809 And I think that exacerbated an existing workforce 345 00:12:51,870 --> 00:12:53,730 challenge that we were already having. 346 00:12:54,190 --> 00:12:55,009 And so 347 00:12:55,389 --> 00:12:56,769 how do we ensure 348 00:12:57,149 --> 00:12:59,009 that we can maximize 349 00:12:59,470 --> 00:13:01,009 what's what's on hand, 350 00:13:01,884 --> 00:13:04,865 by potentially cross training our team more appropriate 351 00:13:04,924 --> 00:13:07,024 and creating care models to include 352 00:13:07,404 --> 00:13:09,745 the use of advanced practice providers, 353 00:13:10,764 --> 00:13:12,144 to create those access. 354 00:13:12,924 --> 00:13:15,085 But also one of the things we're doing 355 00:13:15,085 --> 00:13:16,225 is how do we leverage 356 00:13:16,679 --> 00:13:18,139 technology such as telehealth, 357 00:13:18,919 --> 00:13:19,899 for certain specialties, 358 00:13:20,840 --> 00:13:23,960 such as stroke care to to ensure that 359 00:13:23,960 --> 00:13:25,179 we have timeliness, 360 00:13:26,759 --> 00:13:29,480 of responses to some of these acute care 361 00:13:29,480 --> 00:13:29,980 needs. 362 00:13:30,360 --> 00:13:31,894 And another thing we saw, 363 00:13:32,995 --> 00:13:34,774 you know, at the end of the pandemic 364 00:13:35,075 --> 00:13:36,134 is just the 365 00:13:36,514 --> 00:13:38,774 increase in behavioral health needs, 366 00:13:39,634 --> 00:13:42,295 that enter in our, emergency department, 367 00:13:43,475 --> 00:13:47,220 seeking care. So leveraging technology of virtual consults 368 00:13:47,519 --> 00:13:50,179 to quickly provide access to patients in need, 369 00:13:50,559 --> 00:13:53,299 because it's such a challenging resource 370 00:13:53,840 --> 00:13:57,139 that we experience across the country in terms 371 00:13:57,360 --> 00:13:59,460 of psychiatrists or mental health professionals. 372 00:14:00,545 --> 00:14:02,165 Excuse me. So so certainly, 373 00:14:03,425 --> 00:14:04,565 really recognizing 374 00:14:04,865 --> 00:14:06,565 how we should be able to, 375 00:14:06,945 --> 00:14:09,925 quickly organize about ensuring that we could get 376 00:14:09,985 --> 00:14:11,985 those access to our patient. Because as we 377 00:14:11,985 --> 00:14:15,330 know, at least those virtual consults are providing 378 00:14:15,330 --> 00:14:16,929 the means to be able to do that 379 00:14:16,929 --> 00:14:19,570 do help us to reduce wait times and 380 00:14:19,570 --> 00:14:20,789 help us to increase, 381 00:14:21,330 --> 00:14:23,730 access for patients that may not be able 382 00:14:23,730 --> 00:14:25,970 to travel. We talk about, again, these risk 383 00:14:25,970 --> 00:14:28,715 factors that may challenge or make it difficult 384 00:14:28,715 --> 00:14:30,815 for patients to get to what they need, 385 00:14:30,955 --> 00:14:33,434 but also allows specialists or just for us 386 00:14:33,434 --> 00:14:35,455 to reach a broader, broader population 387 00:14:36,715 --> 00:14:38,815 for sure. Another way, 388 00:14:39,274 --> 00:14:41,294 we we have sort of 389 00:14:41,769 --> 00:14:43,850 took on this challenge is looking for other 390 00:14:43,850 --> 00:14:46,110 ways to create access. And recently, 391 00:14:47,690 --> 00:14:49,629 we were able to, 392 00:14:50,409 --> 00:14:51,309 in a collaborative, 393 00:14:52,169 --> 00:14:54,490 have a collaborative joint venture with one of 394 00:14:54,490 --> 00:14:55,230 our partners, 395 00:14:56,184 --> 00:14:58,184 alongside a partner in a community who's a 396 00:14:58,184 --> 00:14:58,684 multispecialty 397 00:14:59,144 --> 00:15:00,284 physician group 398 00:15:00,825 --> 00:15:04,345 across several location of our region, therefore, helping 399 00:15:04,345 --> 00:15:07,065 us to expand and create more access to 400 00:15:07,065 --> 00:15:09,250 services in the region so that we can 401 00:15:09,250 --> 00:15:09,750 then 402 00:15:10,129 --> 00:15:12,629 really ensure that we are providing 403 00:15:12,929 --> 00:15:13,429 comprehensive, 404 00:15:14,690 --> 00:15:18,449 care across the the continuum. So it's really 405 00:15:18,449 --> 00:15:21,750 being smart about how do you then also, 406 00:15:22,865 --> 00:15:26,705 create care models or work that will support 407 00:15:26,705 --> 00:15:27,445 the ability 408 00:15:27,825 --> 00:15:30,644 to provide the access along 409 00:15:31,184 --> 00:15:32,085 the enterprise. 410 00:15:33,184 --> 00:15:36,404 Because, again, as a system using systemness or, 411 00:15:37,184 --> 00:15:37,684 capacity, 412 00:15:39,200 --> 00:15:41,000 at one space may be able to be 413 00:15:41,000 --> 00:15:41,500 shared 414 00:15:42,279 --> 00:15:44,680 with another space and really creating those type 415 00:15:44,680 --> 00:15:45,420 of loopholes 416 00:15:45,960 --> 00:15:46,620 to really, 417 00:15:47,560 --> 00:15:49,800 narrow the gaps to be able to provide 418 00:15:49,800 --> 00:15:50,620 those access 419 00:15:50,985 --> 00:15:53,464 and be able to provide that, high level 420 00:15:53,464 --> 00:15:55,725 excellent care that we expect for our patients. 421 00:15:55,865 --> 00:15:58,764 So that's one of the priorities we continue 422 00:15:58,825 --> 00:16:01,945 to work in, really looking at using our 423 00:16:01,945 --> 00:16:03,325 community needs assessment 424 00:16:03,945 --> 00:16:04,345 as, 425 00:16:05,940 --> 00:16:08,679 tools that we use to really also gauge, 426 00:16:09,300 --> 00:16:11,139 which is an assessment we do every three 427 00:16:11,139 --> 00:16:14,200 years, to gauge what else in the community, 428 00:16:14,980 --> 00:16:16,440 we need to really prioritize 429 00:16:16,980 --> 00:16:19,059 as we build, whether it's as we create 430 00:16:19,059 --> 00:16:21,554 our budgets, as we as we look at 431 00:16:21,554 --> 00:16:22,774 building new programs, 432 00:16:23,315 --> 00:16:25,634 what is that what what is it informing 433 00:16:25,634 --> 00:16:27,634 us that we need to do so that 434 00:16:27,634 --> 00:16:30,034 we could continue to create those accesses and 435 00:16:30,034 --> 00:16:31,095 provide those services 436 00:16:31,554 --> 00:16:32,375 for our community? 437 00:16:33,649 --> 00:16:35,990 Sounds like a a very multi pronged approach 438 00:16:36,690 --> 00:16:38,850 to improving patient access, filling some of those 439 00:16:38,850 --> 00:16:41,649 specialty care gaps like you mentioned, increasing reliance 440 00:16:41,649 --> 00:16:42,309 on APPs, 441 00:16:43,009 --> 00:16:45,649 thinking about technology in new ways, your new 442 00:16:45,649 --> 00:16:46,549 joint venture. 443 00:16:46,850 --> 00:16:48,710 I appreciate you outlining that. 444 00:16:50,264 --> 00:16:52,024 For the last few minutes here, I wanted 445 00:16:52,024 --> 00:16:54,585 to zoom in specifically on the chief medical 446 00:16:54,585 --> 00:16:58,445 officer role. Right? We're seeing care delivery itself 447 00:16:58,504 --> 00:17:01,004 involved just in response to various industry 448 00:17:01,384 --> 00:17:01,884 factors. 449 00:17:02,504 --> 00:17:04,684 How do you see the CMO role evolving 450 00:17:04,960 --> 00:17:06,180 alongside all of that? 451 00:17:07,680 --> 00:17:08,820 I think it's definitely, 452 00:17:09,600 --> 00:17:12,080 changed. In the last twenty years that I 453 00:17:12,080 --> 00:17:14,160 said I was practicing, I when I look 454 00:17:14,160 --> 00:17:16,400 back and, you know, look at what the 455 00:17:16,400 --> 00:17:17,700 CMO at the organization 456 00:17:18,160 --> 00:17:20,404 that I may have been at is doing 457 00:17:20,465 --> 00:17:22,945 compared to fast forward twenty years later. It's 458 00:17:22,945 --> 00:17:24,404 so significantly different. 459 00:17:24,865 --> 00:17:27,265 You know, back then, the focus was really 460 00:17:27,265 --> 00:17:28,965 on just medical staff, 461 00:17:30,065 --> 00:17:30,565 oversight, 462 00:17:31,025 --> 00:17:34,465 and some clinical operation, ensuring quality of health, 463 00:17:34,465 --> 00:17:35,605 and that is important. 464 00:17:36,440 --> 00:17:37,980 But I think today, 465 00:17:38,680 --> 00:17:40,140 with the with the evolving, 466 00:17:41,480 --> 00:17:44,940 changes constant changing with health care delivery, technology 467 00:17:45,320 --> 00:17:45,820 advancement, 468 00:17:46,680 --> 00:17:49,160 and really the focus on population health, I 469 00:17:49,160 --> 00:17:51,305 think this the chief medical officers have gotta 470 00:17:51,305 --> 00:17:54,025 come along and be really a strategic partner 471 00:17:54,025 --> 00:17:55,945 with the rest of the leadership in the 472 00:17:55,945 --> 00:17:56,445 organization, 473 00:17:57,625 --> 00:17:59,724 to be able to really meet those demands. 474 00:18:00,664 --> 00:18:02,664 Some of the areas that I see us 475 00:18:02,664 --> 00:18:03,724 expanded into 476 00:18:04,159 --> 00:18:06,880 is really population health management. And the reason 477 00:18:06,880 --> 00:18:09,359 why that's really important is because, as you 478 00:18:09,359 --> 00:18:11,919 know, there's a shift from a fee for 479 00:18:11,919 --> 00:18:14,259 service to value based care models. 480 00:18:14,720 --> 00:18:17,200 So the chief medical officers have to play 481 00:18:17,200 --> 00:18:20,115 a real key role in improving patient outcomes 482 00:18:20,174 --> 00:18:21,875 and and across population, 483 00:18:22,414 --> 00:18:23,234 not just 484 00:18:23,535 --> 00:18:24,275 for individual 485 00:18:24,575 --> 00:18:26,595 patients. I just shared 486 00:18:26,974 --> 00:18:30,580 the reason why improving transitions of care so 487 00:18:30,580 --> 00:18:33,320 that we can decrease or manage our readmission 488 00:18:33,539 --> 00:18:36,200 is so important to how we ensure that 489 00:18:36,259 --> 00:18:38,440 we can manage these chronic disease. 490 00:18:39,380 --> 00:18:42,420 We can manage chronic disease condition, but also 491 00:18:42,420 --> 00:18:43,720 make sure there's a handoff 492 00:18:44,065 --> 00:18:45,825 at a different level of care, whether the 493 00:18:45,825 --> 00:18:47,845 handoff is from the inpatient side 494 00:18:48,144 --> 00:18:50,384 to the ambulatory side or the handoff is 495 00:18:50,384 --> 00:18:52,865 from the inpatient side to the sniff or 496 00:18:52,865 --> 00:18:55,345 post acute and vice versa. And how do 497 00:18:55,345 --> 00:18:55,845 we 498 00:18:56,224 --> 00:18:58,724 ensure those transitions are coerced seamlessly 499 00:18:59,400 --> 00:19:01,339 so that we meet the patient demand? 500 00:19:01,960 --> 00:19:04,279 We we also know that we are critically 501 00:19:04,279 --> 00:19:07,339 important in ensuring that we have initiatives around, 502 00:19:07,559 --> 00:19:10,380 again, the social determinants of health and managing 503 00:19:11,000 --> 00:19:13,240 and the health care inequities that we may 504 00:19:13,240 --> 00:19:15,615 see in our communities, in our surrounding, 505 00:19:16,394 --> 00:19:19,034 populations, and how to address those by bringing 506 00:19:19,034 --> 00:19:20,875 in the tools and the resources to do 507 00:19:20,875 --> 00:19:23,115 that. So that overall, we can really be 508 00:19:23,115 --> 00:19:26,315 part of the well-being of the community, not 509 00:19:26,315 --> 00:19:26,815 just, 510 00:19:27,690 --> 00:19:30,669 the well-being at one stage of the patient's 511 00:19:30,730 --> 00:19:33,710 journey of their life. So really multipronged 512 00:19:34,009 --> 00:19:35,390 in that way. Another 513 00:19:36,329 --> 00:19:37,869 key, way that, 514 00:19:38,809 --> 00:19:41,309 we are also involved in ensuring 515 00:19:42,164 --> 00:19:45,384 organization success is workforce well-being and development. 516 00:19:45,924 --> 00:19:47,785 We talk about, you know, 517 00:19:48,085 --> 00:19:50,404 I mentioned we're not immune we were not 518 00:19:50,404 --> 00:19:52,404 immune in health care, not just from the 519 00:19:52,404 --> 00:19:55,065 nurses' perspective, but from physician and other 520 00:19:55,460 --> 00:19:56,359 health care workers, 521 00:19:56,820 --> 00:19:58,359 that burnout is a reality 522 00:19:58,740 --> 00:20:00,839 and becoming a real growing concern. 523 00:20:01,220 --> 00:20:03,880 And as CMOs, I think we're we're critically 524 00:20:03,940 --> 00:20:06,440 important to taking on a larger role addressing 525 00:20:06,500 --> 00:20:08,359 these clinician well-being issues 526 00:20:08,744 --> 00:20:11,085 and promoting healthy workplace culture 527 00:20:11,464 --> 00:20:14,285 with nerds by ensuring we have flexible work, 528 00:20:15,184 --> 00:20:16,204 and, schedules, 529 00:20:16,825 --> 00:20:19,704 ensuring that the EHR is such that we 530 00:20:19,704 --> 00:20:20,664 can unload, 531 00:20:21,065 --> 00:20:22,478 the burden of the clinician in terms of 532 00:20:22,478 --> 00:20:22,744 documentations, facilitating tools to help make sure that 533 00:20:22,744 --> 00:20:23,494 we can 534 00:20:24,220 --> 00:20:24,720 documentations, 535 00:20:25,259 --> 00:20:27,660 facilitating tools to help make sure that we 536 00:20:27,660 --> 00:20:30,799 could manage that really well, promoting a healthy 537 00:20:30,860 --> 00:20:31,920 workplace culture, 538 00:20:32,539 --> 00:20:33,920 I think is also important, 539 00:20:35,100 --> 00:20:36,480 so that we can foster, 540 00:20:37,019 --> 00:20:37,759 that engagement. 541 00:20:38,315 --> 00:20:40,634 But not just that. It's really important from 542 00:20:40,634 --> 00:20:41,934 a retention perspective 543 00:20:42,474 --> 00:20:44,654 to be able to have really good benefits 544 00:20:44,714 --> 00:20:47,615 as well while ensuring that the clinicians 545 00:20:47,914 --> 00:20:49,674 are able to work at the top of 546 00:20:49,674 --> 00:20:50,414 their license 547 00:20:50,795 --> 00:20:52,335 and making sure we can unburden 548 00:20:52,795 --> 00:20:54,015 them with the regulatory, 549 00:20:56,369 --> 00:20:58,529 not regulatory, but just unburden them with the 550 00:20:58,529 --> 00:21:01,250 things that we can take over from them 551 00:21:01,250 --> 00:21:03,089 by doing it in a much more smart 552 00:21:03,089 --> 00:21:03,589 way. 553 00:21:04,529 --> 00:21:06,130 So I think that those are some of 554 00:21:06,130 --> 00:21:06,710 the ways 555 00:21:07,244 --> 00:21:09,964 that CMOs are also involved in terms of 556 00:21:09,964 --> 00:21:12,545 creating a positive workforce culture 557 00:21:12,924 --> 00:21:15,644 to ensure that you're able to recruit the 558 00:21:15,644 --> 00:21:19,085 best talent possible. And, ultimately, not ultimately, and 559 00:21:19,085 --> 00:21:20,305 one one of the, 560 00:21:20,640 --> 00:21:23,380 area I think that I see myself, especially, 561 00:21:23,759 --> 00:21:25,279 and a lot of others as me is 562 00:21:25,279 --> 00:21:29,059 financial oversight. We're in we're increasingly getting involved 563 00:21:29,440 --> 00:21:29,940 in 564 00:21:30,320 --> 00:21:33,519 strategic financial decision. I'm working much more closely 565 00:21:33,519 --> 00:21:35,619 with chief financial officer and CEO, 566 00:21:36,404 --> 00:21:36,904 CEO. 567 00:21:37,365 --> 00:21:39,605 I know for sure I am involved in 568 00:21:39,605 --> 00:21:42,424 all of our budget and annual budgeting processes, 569 00:21:42,805 --> 00:21:45,225 participate in, and really influencing 570 00:21:45,765 --> 00:21:48,904 cost control measures in terms of managing expenses, 571 00:21:49,679 --> 00:21:52,319 also involving growth strategy. Right? When you look 572 00:21:52,319 --> 00:21:54,720 at your revenue streams, where was that look 573 00:21:54,720 --> 00:21:56,319 like? What are some of the things the 574 00:21:56,319 --> 00:21:59,919 market is suggesting that we should focus on 575 00:21:59,919 --> 00:22:00,899 or grow into 576 00:22:01,359 --> 00:22:03,434 or implement implement new, 577 00:22:04,555 --> 00:22:05,055 initiatives. 578 00:22:06,394 --> 00:22:08,634 One of the things I did recently not 579 00:22:08,634 --> 00:22:10,654 recently, but is our robotic program. 580 00:22:11,115 --> 00:22:13,515 While robotic is not new, it is an 581 00:22:13,515 --> 00:22:17,340 important tool to recruit the, physician nowadays because 582 00:22:17,340 --> 00:22:19,180 that's a lot of the way that they're 583 00:22:19,259 --> 00:22:22,220 that they're trained. So bringing that tool also 584 00:22:22,220 --> 00:22:24,160 opens up the ability to have, 585 00:22:24,539 --> 00:22:26,799 an ability to provide to provide more minimally 586 00:22:26,860 --> 00:22:29,200 invasive surgeries for the for the community. 587 00:22:30,154 --> 00:22:32,875 And so really ensuring that we continue that 588 00:22:32,875 --> 00:22:33,855 revenue generation 589 00:22:34,474 --> 00:22:35,694 and really aligning 590 00:22:35,994 --> 00:22:36,815 our financial, 591 00:22:37,595 --> 00:22:38,095 sustainability, 592 00:22:39,434 --> 00:22:40,575 along our KPIs. 593 00:22:41,275 --> 00:22:43,859 So really making sure that we are fiscally 594 00:22:43,919 --> 00:22:45,140 doing that in a way 595 00:22:45,519 --> 00:22:47,779 that, is aligned with the organizational, 596 00:22:49,759 --> 00:22:51,460 organizational goals. Sorry. 597 00:22:51,839 --> 00:22:53,380 So those are some of the ways 598 00:22:53,759 --> 00:22:54,899 I think CMOs 599 00:22:55,359 --> 00:22:56,099 have pivoted, 600 00:22:57,105 --> 00:22:59,585 over the years to really be really much 601 00:23:00,065 --> 00:23:03,045 definitely a huge value add and strategic partner 602 00:23:03,424 --> 00:23:05,365 with the rest of the leadership 603 00:23:05,744 --> 00:23:07,045 structure in the organization. 604 00:23:07,744 --> 00:23:08,244 Mhmm. 605 00:23:08,625 --> 00:23:10,164 It's clear the CMOs, 606 00:23:11,200 --> 00:23:14,640 you know, strategic oversight has significantly expanded and 607 00:23:14,640 --> 00:23:16,799 and will continue to, and I think you 608 00:23:16,799 --> 00:23:19,200 are a living example of a clinical executive 609 00:23:19,200 --> 00:23:19,920 who is, 610 00:23:20,320 --> 00:23:22,720 so passionate and driven in, to do what's 611 00:23:22,720 --> 00:23:24,960 best for their community, their patients, and their 612 00:23:24,960 --> 00:23:26,180 staff members. So 613 00:23:26,515 --> 00:23:27,875 thank you so much for your time today. 614 00:23:27,875 --> 00:23:29,875 This has been such an enlightening discussion, and 615 00:23:29,875 --> 00:23:31,974 I appreciate you sharing more about your work. 616 00:23:32,515 --> 00:23:35,075 Yeah. I appreciate the opportunity to chat with 617 00:23:35,075 --> 00:23:36,054 you a little bit. 618 00:23:36,515 --> 00:23:38,035 I know I'm gonna see some of you 619 00:23:38,035 --> 00:23:40,679 in different spaces. I'm gonna be at the 620 00:23:40,679 --> 00:23:43,480 annual conference soon, and, really, it's been a 621 00:23:43,480 --> 00:23:45,559 pleasure to, you know, work with some of 622 00:23:45,559 --> 00:23:48,519 your teams in different spaces. So appreciate the 623 00:23:48,519 --> 00:23:51,000 opportunity to share some of the the work 624 00:23:51,000 --> 00:23:53,659 that I do and what keeps me, motivated.