1 00:00:00,160 --> 00:00:02,399 This is Laura Dirda with the Becker's Healthcare 2 00:00:02,399 --> 00:00:04,559 podcast. I'm thrilled today to be joined by 3 00:00:04,559 --> 00:00:07,519 doctor Danny Heckner, chief clinical officer at South 4 00:00:07,519 --> 00:00:09,839 Coast Health System. Doctor Heckner, it's a pleasure 5 00:00:09,839 --> 00:00:11,300 to have you on the podcast today. 6 00:00:11,679 --> 00:00:13,219 A pleasure to be here, Laura. 7 00:00:13,835 --> 00:00:15,674 Now I'm excited to have you as part 8 00:00:15,674 --> 00:00:18,234 of this conversation because I know, we'll talk 9 00:00:18,234 --> 00:00:19,594 about some of the cool things we're doing 10 00:00:19,594 --> 00:00:22,015 at South Coast, particularly in looking at, 11 00:00:22,714 --> 00:00:25,914 digital innovation and quality on technology side and 12 00:00:25,914 --> 00:00:28,609 and delivering that into patients as well for 13 00:00:28,670 --> 00:00:30,829 positive change. But before we dive into that 14 00:00:30,829 --> 00:00:33,070 discussion, I'm curious. Could you tell us a 15 00:00:33,070 --> 00:00:35,009 little bit more about yourself and your background? 16 00:00:36,270 --> 00:00:39,884 Sure. I'm a Sears UCLA trained pulmonary critical 17 00:00:39,884 --> 00:00:40,704 care physician, 18 00:00:41,085 --> 00:00:44,045 still clinically active. I serve as chief clinical 19 00:00:44,045 --> 00:00:45,504 officer of South Coast Health, 20 00:00:46,045 --> 00:00:47,184 300,000 21 00:00:47,244 --> 00:00:47,744 catchment 22 00:00:48,604 --> 00:00:50,864 hospital system in Massachusetts, 23 00:00:52,284 --> 00:00:55,024 but also serving, Rhode Island as well. 24 00:00:55,380 --> 00:00:56,760 I currently hold the Goodspeed, 25 00:00:57,299 --> 00:00:59,479 chair of quality of safety at South Coast 26 00:00:59,780 --> 00:01:00,520 and also 27 00:01:01,219 --> 00:01:03,700 serve as an associate professor at UMass Chan 28 00:01:03,700 --> 00:01:06,180 Medical School. I served as one of the 29 00:01:06,180 --> 00:01:08,145 core members of the road map to health 30 00:01:08,145 --> 00:01:09,605 care safety in Massachusetts, 31 00:01:10,465 --> 00:01:12,545 which was presented at the health care policy 32 00:01:12,545 --> 00:01:13,045 forum 33 00:01:13,424 --> 00:01:15,045 in April 23. 34 00:01:15,745 --> 00:01:18,625 At the hospitals, your physician advisers may have 35 00:01:18,625 --> 00:01:19,125 trained, 36 00:01:19,825 --> 00:01:22,784 with the Compass PA program from the American 37 00:01:22,784 --> 00:01:24,209 Case Management Association 38 00:01:24,909 --> 00:01:26,049 that I helped develop. 39 00:01:26,989 --> 00:01:27,310 And, 40 00:01:27,950 --> 00:01:30,909 lastly, I'm trained in health care coaching through 41 00:01:30,909 --> 00:01:32,530 the Health Care Coaching Academy. 42 00:01:33,310 --> 00:01:35,469 The most important thing is I'm a Boston 43 00:01:35,469 --> 00:01:35,969 Celtics 44 00:01:36,645 --> 00:01:38,724 and LA Galaxy fan. There are not many 45 00:01:38,724 --> 00:01:41,465 of those. A father of five and occasional 46 00:01:41,844 --> 00:01:43,145 volunteer soccer coach. 47 00:01:43,924 --> 00:01:46,165 Oh, it's fantastic to hear. And, you know, 48 00:01:46,165 --> 00:01:48,025 I was curious. How did you become a 49 00:01:48,325 --> 00:01:50,424 a a fan of both Celtics and LA? 50 00:01:51,079 --> 00:01:53,879 Well, I originally came, with my family. My 51 00:01:53,879 --> 00:01:54,359 dad, 52 00:01:55,079 --> 00:01:57,640 was born in South Africa and and served 53 00:01:57,640 --> 00:02:00,060 as a family doc, got interested in anesthesia, 54 00:02:00,680 --> 00:02:02,379 and brought the family to Boston, 55 00:02:02,680 --> 00:02:03,180 became 56 00:02:03,835 --> 00:02:05,995 a a Celtics Red Sox fan at that 57 00:02:05,995 --> 00:02:07,674 time. We eventually made our way to the 58 00:02:07,674 --> 00:02:08,814 West Coast 59 00:02:09,115 --> 00:02:09,615 and, 60 00:02:10,395 --> 00:02:12,014 long time Galaxy fan, 61 00:02:13,194 --> 00:02:13,995 with my kids, 62 00:02:14,474 --> 00:02:14,875 and, 63 00:02:15,275 --> 00:02:17,455 so pleased to see two championships 64 00:02:17,754 --> 00:02:18,814 in the past year. 65 00:02:20,209 --> 00:02:23,569 Yeah. Absolutely. That is super, super impressive and 66 00:02:23,569 --> 00:02:24,870 a lot of fun. So, 67 00:02:25,250 --> 00:02:26,469 really cool. Well, 68 00:02:26,930 --> 00:02:29,090 thank you again for for jumping in here. 69 00:02:29,729 --> 00:02:31,409 Could you tell us also as well a 70 00:02:31,409 --> 00:02:34,129 little bit about what's driving quality and safety 71 00:02:34,129 --> 00:02:36,105 journey that you're on at South Coast. How 72 00:02:36,105 --> 00:02:37,485 are you thinking about the transformation? 73 00:02:39,385 --> 00:02:41,544 So in my early career, I did work 74 00:02:41,544 --> 00:02:43,544 at Cedars in the rollout of the core 75 00:02:43,544 --> 00:02:44,685 measures in medicine, 76 00:02:45,305 --> 00:02:47,085 and we developed point of care decision 77 00:02:47,385 --> 00:02:47,885 support, 78 00:02:48,479 --> 00:02:51,060 to augment very limited quality labor. 79 00:02:51,439 --> 00:02:53,199 And at South Coast, we've been on a 80 00:02:53,199 --> 00:02:54,419 very similar mission, 81 00:02:55,520 --> 00:02:58,099 to drive real time clinical collaboration 82 00:02:59,120 --> 00:03:00,340 within limitations, 83 00:03:01,439 --> 00:03:02,340 that our current 84 00:03:03,084 --> 00:03:05,504 market and and and and current, 85 00:03:06,125 --> 00:03:06,625 staffing 86 00:03:07,164 --> 00:03:07,664 require. 87 00:03:08,604 --> 00:03:12,044 Using augmenting tech technology, we're really driving those 88 00:03:12,044 --> 00:03:14,284 five core elements of the road map to 89 00:03:14,284 --> 00:03:15,584 health care safety, 90 00:03:16,500 --> 00:03:19,000 including leadership and safety culture, 91 00:03:19,699 --> 00:03:22,120 operations that embed safety behaviors, 92 00:03:22,900 --> 00:03:25,000 patient family and caregiver support, 93 00:03:26,099 --> 00:03:27,239 workforce well-being, 94 00:03:27,780 --> 00:03:28,840 and then a commitment 95 00:03:29,185 --> 00:03:31,924 to measurement, measurement, measurement, and transparency. 96 00:03:33,664 --> 00:03:35,424 Absolutely. I I think that makes a lot 97 00:03:35,424 --> 00:03:37,125 of sense. And, you know, I really, 98 00:03:37,664 --> 00:03:40,305 love that emphasis on being able to not 99 00:03:40,305 --> 00:03:42,384 only elevate the safety aspect of it, but 100 00:03:42,384 --> 00:03:44,324 then to have the measurement, 101 00:03:44,969 --> 00:03:47,150 clear metrics and transparency as well. 102 00:03:47,610 --> 00:03:50,090 How easy or or difficult is it to 103 00:03:50,090 --> 00:03:51,150 make that transformation? 104 00:03:51,449 --> 00:03:54,189 Obviously, the technology side is one thing, but 105 00:03:54,330 --> 00:03:56,909 on the people side as well. I'm curious, 106 00:03:57,370 --> 00:03:58,349 from your perspective, 107 00:03:58,935 --> 00:04:02,215 what, have been helpful in how have you 108 00:04:02,215 --> 00:04:04,295 kind of navigated the people side of this 109 00:04:04,295 --> 00:04:05,194 type of transformation? 110 00:04:07,015 --> 00:04:09,495 So in that first area, leadership and safety 111 00:04:09,495 --> 00:04:09,995 culture, 112 00:04:10,900 --> 00:04:12,919 we have to have sensitivity to operations. 113 00:04:13,460 --> 00:04:15,080 We have to keep the walls up. 114 00:04:15,379 --> 00:04:16,920 We we have to treat 115 00:04:17,860 --> 00:04:18,360 throughput, 116 00:04:19,060 --> 00:04:21,080 emergency access, primary access, 117 00:04:21,620 --> 00:04:22,120 and 118 00:04:22,660 --> 00:04:26,120 and specialty access as quality and safety issues. 119 00:04:27,634 --> 00:04:28,375 And yet, 120 00:04:28,754 --> 00:04:31,014 at the core of all of those operations 121 00:04:31,555 --> 00:04:32,615 are human beings. 122 00:04:33,394 --> 00:04:34,295 So it means, 123 00:04:35,555 --> 00:04:36,454 really emphasizing 124 00:04:37,314 --> 00:04:38,615 deference to those 125 00:04:38,970 --> 00:04:41,069 human beings' experience, but also 126 00:04:41,449 --> 00:04:42,830 their clinical expertise. 127 00:04:43,850 --> 00:04:46,650 One of, you know, the key elements is 128 00:04:46,650 --> 00:04:49,389 building strong dyadic tri triadic, 129 00:04:50,170 --> 00:04:50,670 leadership. 130 00:04:51,370 --> 00:04:53,870 So every every one of my clinical leaders 131 00:04:54,235 --> 00:04:56,654 has an operations leader at their elbow, 132 00:04:57,355 --> 00:04:57,855 and 133 00:04:58,555 --> 00:05:01,355 and they they listen to the clinicians in 134 00:05:01,355 --> 00:05:02,014 the field. 135 00:05:02,395 --> 00:05:04,555 They listen to the front office staff, and 136 00:05:04,555 --> 00:05:05,935 and together, you drive 137 00:05:06,850 --> 00:05:07,350 operations 138 00:05:08,290 --> 00:05:09,590 that that are are conscientious, 139 00:05:10,449 --> 00:05:11,430 that are thoughtful. 140 00:05:12,290 --> 00:05:14,449 And we've seen this really have a major 141 00:05:14,449 --> 00:05:17,350 impact on on on experience scores. 142 00:05:17,970 --> 00:05:20,050 We're running experience scores in our group in 143 00:05:20,050 --> 00:05:20,790 the nineties. 144 00:05:21,569 --> 00:05:24,254 I think primary care may be 89. 145 00:05:25,435 --> 00:05:26,334 We're seeing, 146 00:05:27,355 --> 00:05:27,855 well-being, 147 00:05:29,035 --> 00:05:31,134 reported in our culture of safety, 148 00:05:32,235 --> 00:05:32,735 surveys, 149 00:05:33,595 --> 00:05:36,415 and we're seeing improvements even in hard hit 150 00:05:36,714 --> 00:05:37,855 inpatient areas. 151 00:05:39,089 --> 00:05:41,730 And it's great to see such positive results 152 00:05:41,730 --> 00:05:43,270 there and truly, truly, 153 00:05:43,810 --> 00:05:46,209 serving the community and patients in a meaningful 154 00:05:46,209 --> 00:05:46,709 way. 155 00:05:47,170 --> 00:05:49,089 I'm wondering, what are some of the digital 156 00:05:49,089 --> 00:05:51,350 and quality technologies that have helped you accelerate 157 00:05:51,410 --> 00:05:52,629 this positive change? 158 00:05:53,865 --> 00:05:56,584 So South Coast marks its tenth year of 159 00:05:56,584 --> 00:05:58,764 investing in EPIC and robust tools, 160 00:05:59,865 --> 00:06:01,884 to enhance clinical care. 161 00:06:02,264 --> 00:06:04,524 We're a premier client for our data warehousing 162 00:06:04,665 --> 00:06:05,404 and benchmarking 163 00:06:06,230 --> 00:06:08,810 capabilities. We're also an NRC client 164 00:06:09,110 --> 00:06:09,930 for benchmarked 165 00:06:10,230 --> 00:06:11,290 experience data. 166 00:06:12,069 --> 00:06:12,810 Our visualization 167 00:06:13,350 --> 00:06:14,889 platform is Tableau. 168 00:06:16,310 --> 00:06:19,110 And then we've also adopt adopted some of 169 00:06:19,110 --> 00:06:20,170 the needed elements, 170 00:06:21,110 --> 00:06:23,495 such as Compass Rose for care navigation, 171 00:06:23,955 --> 00:06:25,335 MyChart care companion, 172 00:06:26,194 --> 00:06:29,175 which is very similar to other commercial products 173 00:06:29,634 --> 00:06:31,574 for patient education and engagement. 174 00:06:32,835 --> 00:06:35,634 But we also have an innovation arm called 175 00:06:35,634 --> 00:06:37,095 Compodio that invests 176 00:06:37,430 --> 00:06:40,169 that invests in educational and improvement technology 177 00:06:41,349 --> 00:06:43,430 and also brings some of our innovation to 178 00:06:43,430 --> 00:06:44,089 the market. 179 00:06:44,709 --> 00:06:47,689 We're a level 10 CHIME most wired organization, 180 00:06:48,389 --> 00:06:50,729 so we're very much committed to this nexus 181 00:06:50,870 --> 00:06:51,314 of 182 00:06:51,714 --> 00:06:53,014 of of people and technology. 183 00:06:54,514 --> 00:06:56,435 You know, lastly, we have an AI center 184 00:06:56,435 --> 00:06:57,014 of excellence. 185 00:06:57,795 --> 00:06:59,574 It's recognized by American 186 00:07:00,274 --> 00:07:01,254 College of Radiology. 187 00:07:02,675 --> 00:07:03,894 We use AI 188 00:07:04,274 --> 00:07:05,720 to manage cues, 189 00:07:06,339 --> 00:07:07,639 never to diagnose 190 00:07:08,100 --> 00:07:09,639 but to enhance throughput. 191 00:07:10,580 --> 00:07:11,060 And, 192 00:07:11,620 --> 00:07:12,600 and all of these 193 00:07:13,139 --> 00:07:14,120 digital applications 194 00:07:14,580 --> 00:07:16,279 together in a thoughtful way, 195 00:07:17,300 --> 00:07:19,240 can, can make a difference. 196 00:07:20,805 --> 00:07:22,485 Absolutely. That makes a lot of sense, and 197 00:07:22,485 --> 00:07:23,785 I appreciate you outlining 198 00:07:24,245 --> 00:07:25,045 some of the different, 199 00:07:25,524 --> 00:07:27,845 technologies that have supported you through these journeys. 200 00:07:27,845 --> 00:07:30,805 It's oppressive to hear, the level 10 chime 201 00:07:30,805 --> 00:07:33,060 in in most wired recognitions as well as 202 00:07:33,300 --> 00:07:35,319 the others from the American College of Radiology 203 00:07:35,699 --> 00:07:37,399 in in other areas that, 204 00:07:37,699 --> 00:07:38,919 truly, you know, 205 00:07:39,779 --> 00:07:41,699 show how distinguished you are in the things 206 00:07:41,699 --> 00:07:43,699 that you're doing at South Coast. That that's 207 00:07:43,699 --> 00:07:44,839 really cool to hear. 208 00:07:45,220 --> 00:07:47,540 In achieving or or making these achievements, how 209 00:07:47,540 --> 00:07:50,134 has your team evolved throughout this journey? 210 00:07:51,154 --> 00:07:54,035 Well, I'd I'd like to act, sort of 211 00:07:54,035 --> 00:07:54,535 just, 212 00:07:55,475 --> 00:07:57,074 you know, pull back the covers a little 213 00:07:57,074 --> 00:07:58,375 bit and just explain, 214 00:07:59,394 --> 00:07:59,894 before 215 00:08:01,229 --> 00:08:03,169 how we apply the technology. 216 00:08:04,110 --> 00:08:05,169 We have a fairly, 217 00:08:07,229 --> 00:08:09,810 simple approach at at a high level. 218 00:08:10,910 --> 00:08:12,289 So we like to combine, 219 00:08:13,550 --> 00:08:16,610 available raw financial and operational data 220 00:08:17,444 --> 00:08:18,245 together with, 221 00:08:18,884 --> 00:08:19,384 processed 222 00:08:20,245 --> 00:08:21,144 risk adjusted 223 00:08:21,764 --> 00:08:22,264 data. 224 00:08:23,125 --> 00:08:24,745 And we like to share it 225 00:08:25,685 --> 00:08:26,185 across 226 00:08:26,725 --> 00:08:29,225 our our organization from the board 227 00:08:29,920 --> 00:08:30,660 to the front front 228 00:08:31,279 --> 00:08:31,779 line. 229 00:08:32,639 --> 00:08:34,740 And the way to do that is delivering 230 00:08:35,200 --> 00:08:37,139 simple, meaningful visualizations 231 00:08:37,679 --> 00:08:38,340 to staff 232 00:08:39,279 --> 00:08:41,460 so they then have choice 233 00:08:42,024 --> 00:08:42,845 and engagement, 234 00:08:43,384 --> 00:08:43,884 understanding, 235 00:08:45,065 --> 00:08:47,144 and then can decide on their test of 236 00:08:47,144 --> 00:08:48,684 change. They can, 237 00:08:49,945 --> 00:08:51,644 engage in idea generation. 238 00:08:52,105 --> 00:08:52,764 They can 239 00:08:53,225 --> 00:08:54,125 course correct, 240 00:08:54,580 --> 00:08:55,480 and, most importantly, 241 00:08:55,940 --> 00:08:57,960 internalize the improvement process. 242 00:09:00,339 --> 00:09:02,899 So, you know, our organization and I believe 243 00:09:02,899 --> 00:09:04,039 that health care personnel 244 00:09:04,899 --> 00:09:07,955 are highly creative, and they're internally driven, but 245 00:09:07,955 --> 00:09:09,014 it's our responsibility 246 00:09:10,195 --> 00:09:12,595 to give them the tools, including the digital 247 00:09:12,595 --> 00:09:13,095 tools. 248 00:09:13,794 --> 00:09:17,014 As we've talked about earlier, it's really important 249 00:09:17,235 --> 00:09:19,335 that we recognize the human factors, 250 00:09:20,620 --> 00:09:23,279 and we have to find ways to 251 00:09:24,299 --> 00:09:26,319 join robust process improvement 252 00:09:27,500 --> 00:09:28,799 and agile workouts 253 00:09:29,659 --> 00:09:30,159 with 254 00:09:31,579 --> 00:09:32,319 an understanding 255 00:09:32,620 --> 00:09:33,360 of the experience 256 00:09:34,715 --> 00:09:37,055 of the providers and staff in the moment. 257 00:09:38,715 --> 00:09:41,355 Folks have had probably one of the toughest 258 00:09:41,355 --> 00:09:42,415 seasons in 259 00:09:43,195 --> 00:09:45,935 in in seven years with with the flu 260 00:09:46,840 --> 00:09:49,419 this this past winter. And 261 00:09:49,879 --> 00:09:52,620 how can we, even during that really tough 262 00:09:52,840 --> 00:09:53,340 season, 263 00:09:53,960 --> 00:09:57,080 maintain and improve the experience of providers which 264 00:09:57,080 --> 00:09:57,820 we have? 265 00:09:58,360 --> 00:10:00,355 And and it's this combination 266 00:10:00,815 --> 00:10:02,595 of attentiveness to 267 00:10:03,214 --> 00:10:04,754 the the quality methodologies 268 00:10:05,054 --> 00:10:07,235 and and the digital tools, but also 269 00:10:08,014 --> 00:10:10,514 the experience of the individual in the moment. 270 00:10:11,615 --> 00:10:14,194 You know, to do that, it sometimes requires 271 00:10:14,549 --> 00:10:16,009 that we step back 272 00:10:16,629 --> 00:10:17,370 as leaders 273 00:10:17,750 --> 00:10:18,250 and 274 00:10:18,629 --> 00:10:19,450 and allow 275 00:10:19,909 --> 00:10:21,769 our teams and leaders 276 00:10:22,629 --> 00:10:25,210 to innovate, to stub their toes. 277 00:10:25,750 --> 00:10:28,785 Other times, we really should look beyond our 278 00:10:28,785 --> 00:10:29,764 own institutions. 279 00:10:30,304 --> 00:10:32,804 We've had wonderful collaborations with organizations 280 00:10:33,105 --> 00:10:34,804 like the Betsy Lehman Center, 281 00:10:35,264 --> 00:10:37,285 the CDC see difference collaborative, 282 00:10:38,545 --> 00:10:40,725 our local public health officials, 283 00:10:41,345 --> 00:10:43,205 such as our new New Bedford 284 00:10:43,740 --> 00:10:46,620 and Fall River Public Health Leaders and and 285 00:10:46,620 --> 00:10:50,559 then national organizations like NACCO, the National Association 286 00:10:50,620 --> 00:10:52,080 of Community Health Officials. 287 00:10:52,500 --> 00:10:53,000 And, 288 00:10:53,419 --> 00:10:56,960 you know, sometimes leaders in a particular system 289 00:10:57,019 --> 00:10:59,120 really need to just listen, 290 00:10:59,485 --> 00:11:02,044 you know, outside of your own system and 291 00:11:02,044 --> 00:11:04,445 and then bring in some of those best 292 00:11:04,445 --> 00:11:04,945 practices 293 00:11:05,325 --> 00:11:06,544 and and learnings. 294 00:11:07,644 --> 00:11:10,205 So at South Coast, we're committed to making 295 00:11:10,205 --> 00:11:11,504 a meaningful difference, 296 00:11:13,049 --> 00:11:14,829 and it and and it involves, 297 00:11:15,929 --> 00:11:17,389 really a lot of thoughtfulness, 298 00:11:17,929 --> 00:11:18,589 but also 299 00:11:19,129 --> 00:11:21,870 humility before the the data and the people. 300 00:11:22,730 --> 00:11:25,610 So to really get to your question on 301 00:11:25,610 --> 00:11:26,909 how the team has evolved 302 00:11:27,735 --> 00:11:28,715 through this journey, 303 00:11:29,335 --> 00:11:30,794 the team is really committed 304 00:11:31,495 --> 00:11:32,875 to an open 305 00:11:33,254 --> 00:11:34,075 and collaborative 306 00:11:35,414 --> 00:11:37,355 as well as distributed approach 307 00:11:37,735 --> 00:11:38,475 to improvement. 308 00:11:39,735 --> 00:11:40,235 So 309 00:11:40,855 --> 00:11:43,699 it it's a a normal practice at South 310 00:11:43,699 --> 00:11:46,199 Coast to embed quality staff 311 00:11:46,579 --> 00:11:48,039 in a clinical area, 312 00:11:48,419 --> 00:11:49,159 such as 313 00:11:50,179 --> 00:11:52,120 our top rated three star 314 00:11:53,059 --> 00:11:53,559 cabbage 315 00:11:54,100 --> 00:11:57,000 program and our wonderful structural heart program. 316 00:11:58,875 --> 00:12:01,615 That quality staff is seen as part of, 317 00:12:02,154 --> 00:12:05,035 the operation and, of course, can't do do 318 00:12:05,035 --> 00:12:07,054 everything. That's where the dyadic, 319 00:12:07,835 --> 00:12:08,335 triadic 320 00:12:08,875 --> 00:12:10,654 relationships come into play. 321 00:12:11,509 --> 00:12:12,169 And then 322 00:12:12,710 --> 00:12:15,690 in areas where we've seen need, we've replicated 323 00:12:16,070 --> 00:12:16,809 best practices 324 00:12:17,750 --> 00:12:19,610 across disciplines and geographies. 325 00:12:19,990 --> 00:12:20,490 So 326 00:12:21,269 --> 00:12:22,570 when we saw an opportunity 327 00:12:23,350 --> 00:12:24,809 with our wonderful nursing 328 00:12:25,669 --> 00:12:26,649 staff to 329 00:12:27,804 --> 00:12:29,184 develop professional practice 330 00:12:29,964 --> 00:12:33,084 and simulation training and and a number of 331 00:12:33,084 --> 00:12:33,584 other 332 00:12:34,044 --> 00:12:34,544 elements, 333 00:12:35,325 --> 00:12:36,144 we replicated 334 00:12:36,445 --> 00:12:37,745 what may have been available, 335 00:12:38,764 --> 00:12:39,264 to 336 00:12:39,920 --> 00:12:42,320 to another part of our center or even 337 00:12:42,320 --> 00:12:44,660 what was available outside our center. 338 00:12:45,200 --> 00:12:47,680 So now, for instance, nursing peer review is 339 00:12:47,680 --> 00:12:48,420 on par 340 00:12:48,800 --> 00:12:50,500 with physician and HPAPP 341 00:12:51,600 --> 00:12:52,340 peer review. 342 00:12:54,014 --> 00:12:57,075 We've also developed and mentored leaders because 343 00:12:58,095 --> 00:13:01,235 in some areas, folks just haven't had exposure 344 00:13:02,254 --> 00:13:02,754 to 345 00:13:03,134 --> 00:13:05,294 the challenge and, frankly, some of the mistakes 346 00:13:05,294 --> 00:13:07,554 we've made in other areas and learned from 347 00:13:08,279 --> 00:13:09,179 and and mentoring, 348 00:13:09,720 --> 00:13:10,220 developing 349 00:13:10,919 --> 00:13:12,539 leaders that are motivated 350 00:13:13,399 --> 00:13:15,339 and and enjoy this approach 351 00:13:16,679 --> 00:13:18,379 has really yielded wonderful 352 00:13:18,839 --> 00:13:19,339 results. 353 00:13:20,375 --> 00:13:22,955 In some cases, we've sent folks to 354 00:13:23,414 --> 00:13:25,434 individual leadership training programs. 355 00:13:26,134 --> 00:13:26,634 I've 356 00:13:27,095 --> 00:13:29,495 I've had some success with the Harvard women's 357 00:13:29,495 --> 00:13:30,475 leadership program, 358 00:13:31,095 --> 00:13:31,414 and, 359 00:13:31,894 --> 00:13:34,235 we've really turned the light on. 360 00:13:35,120 --> 00:13:37,379 One of our hospitalist leaders, 361 00:13:38,000 --> 00:13:39,779 did a wonderful AI program. 362 00:13:40,879 --> 00:13:42,740 And, and so there are many 363 00:13:43,120 --> 00:13:44,659 ways to mentor and develop 364 00:13:45,759 --> 00:13:48,019 on both the technology side, but also 365 00:13:48,815 --> 00:13:50,914 on on the human side. 366 00:13:51,774 --> 00:13:52,514 And lastly, 367 00:13:53,054 --> 00:13:54,274 you know, we've gotta flex 368 00:13:54,975 --> 00:13:56,914 our our muscles in this area 369 00:13:57,534 --> 00:13:59,855 even when events do not occur. And one 370 00:13:59,855 --> 00:14:01,634 of the best ways to do that 371 00:14:02,495 --> 00:14:04,649 and and to keep trained up is case 372 00:14:04,649 --> 00:14:05,470 based learning. 373 00:14:06,490 --> 00:14:09,210 So we do simulation training and case based 374 00:14:09,210 --> 00:14:09,710 learning 375 00:14:10,250 --> 00:14:10,990 with multidisciplinary 376 00:14:11,529 --> 00:14:12,029 teams. 377 00:14:13,210 --> 00:14:13,610 And, 378 00:14:14,490 --> 00:14:16,330 and I do a very similar session at 379 00:14:16,330 --> 00:14:18,250 the Harvard School of Public Health in the 380 00:14:18,250 --> 00:14:18,750 summer, 381 00:14:19,504 --> 00:14:20,164 for a day, 382 00:14:20,705 --> 00:14:22,865 where we look at case based learning around 383 00:14:22,865 --> 00:14:24,004 the leadership challenge. 384 00:14:25,424 --> 00:14:28,804 And and these approaches within the health system 385 00:14:29,024 --> 00:14:31,840 are very well received. You'll have a a 386 00:14:31,840 --> 00:14:34,480 risk manager next to a quality nurse, next 387 00:14:34,480 --> 00:14:36,740 to a professional practice peer review, 388 00:14:37,600 --> 00:14:38,100 specialist, 389 00:14:38,799 --> 00:14:40,019 next to a provider 390 00:14:40,639 --> 00:14:41,139 physician 391 00:14:41,840 --> 00:14:44,659 APP, next to an operations person, 392 00:14:45,039 --> 00:14:46,740 and work through some challenging 393 00:14:48,214 --> 00:14:48,714 events. 394 00:14:49,654 --> 00:14:51,754 And we've dealt with issues such as workplace 395 00:14:51,975 --> 00:14:52,954 violence, which 396 00:14:53,975 --> 00:14:54,794 can be, 397 00:14:55,254 --> 00:14:56,934 you know, can be dealt with in a 398 00:14:56,934 --> 00:14:57,434 simulation 399 00:14:58,054 --> 00:14:58,554 environment 400 00:14:59,014 --> 00:14:59,834 quite safely, 401 00:15:00,294 --> 00:15:03,240 but helps folks to prepare, helps folks to 402 00:15:03,240 --> 00:15:04,299 address some of, 403 00:15:05,080 --> 00:15:07,320 some of the challenges, but also some of 404 00:15:07,320 --> 00:15:08,299 the opportunities. 405 00:15:09,720 --> 00:15:11,500 That's great to hear. And and certainly, 406 00:15:12,360 --> 00:15:12,860 such 407 00:15:13,309 --> 00:15:14,379 a, important 408 00:15:15,325 --> 00:15:17,644 aspects you're talking about here in in continuing 409 00:15:17,644 --> 00:15:20,144 education and learning and how people can grow, 410 00:15:20,445 --> 00:15:21,504 with new opportunities 411 00:15:21,884 --> 00:15:25,264 as well as elevate themselves throughout their careers. 412 00:15:25,644 --> 00:15:27,565 I'm curious before we wrap up here, what 413 00:15:27,565 --> 00:15:29,325 are you most excited about for the next 414 00:15:29,325 --> 00:15:30,705 year, and what makes you nervous? 415 00:15:32,100 --> 00:15:32,600 Well, 416 00:15:33,540 --> 00:15:35,320 I would say I'm very excited 417 00:15:36,019 --> 00:15:36,519 about 418 00:15:36,899 --> 00:15:40,500 our work on empathy training. We partnered with 419 00:15:40,500 --> 00:15:43,540 a wonderful evidence based program, the company called 420 00:15:43,540 --> 00:15:44,040 Empathetics, 421 00:15:44,660 --> 00:15:46,120 doing a train the trainer 422 00:15:46,504 --> 00:15:48,365 program rolled out to our hospitalists. 423 00:15:49,705 --> 00:15:52,264 We learned from an organization on the West 424 00:15:52,264 --> 00:15:53,065 Coast that, 425 00:15:53,625 --> 00:15:54,605 did very well 426 00:15:55,144 --> 00:15:56,044 with the program, 427 00:15:56,504 --> 00:15:59,065 and, we're continuing to roll it out for 428 00:15:59,065 --> 00:16:00,524 hospital based providers, 429 00:16:01,419 --> 00:16:02,240 this winter 430 00:16:02,700 --> 00:16:03,600 and spring. 431 00:16:04,220 --> 00:16:06,540 I'm also very excited about our dementia work 432 00:16:06,540 --> 00:16:08,879 with the guide program, and this brings folks 433 00:16:09,100 --> 00:16:09,600 from 434 00:16:10,379 --> 00:16:11,519 across the system, 435 00:16:11,980 --> 00:16:13,200 ambulatory, inpatient, 436 00:16:14,975 --> 00:16:16,995 home health, and and beyond. 437 00:16:17,855 --> 00:16:20,274 We're including innovations from compodio. 438 00:16:20,735 --> 00:16:24,355 We're using some new technology on AI language 439 00:16:24,975 --> 00:16:26,595 and visual recognition, 440 00:16:27,690 --> 00:16:28,170 and, 441 00:16:28,649 --> 00:16:30,730 we're embedding it in our brain and spine 442 00:16:30,730 --> 00:16:31,710 center, an ambulatory 443 00:16:32,169 --> 00:16:33,230 memory clinic, 444 00:16:33,769 --> 00:16:35,870 you know, that has, guide support. 445 00:16:37,129 --> 00:16:37,450 And, 446 00:16:38,330 --> 00:16:40,509 lastly, I'm very excited about 447 00:16:40,970 --> 00:16:42,110 the overall journey 448 00:16:42,475 --> 00:16:43,294 to high reliability, 449 00:16:44,875 --> 00:16:45,934 you know, supporting, 450 00:16:46,794 --> 00:16:48,894 our movement and our star ratings 451 00:16:49,754 --> 00:16:50,235 and, 452 00:16:50,715 --> 00:16:52,975 and and the well-being of 453 00:16:53,674 --> 00:16:55,615 of our our staff and community. 454 00:16:56,259 --> 00:16:58,100 What am I worried about in the coming 455 00:16:58,100 --> 00:16:58,600 year? 456 00:17:00,179 --> 00:17:01,879 Health care is really tough, 457 00:17:02,419 --> 00:17:04,919 at this time. It's a market 458 00:17:05,299 --> 00:17:06,440 that's quite disrupted. 459 00:17:08,179 --> 00:17:09,160 On one hand, 460 00:17:10,099 --> 00:17:10,599 increased 461 00:17:11,295 --> 00:17:11,795 compensation, 462 00:17:13,055 --> 00:17:13,875 for labor 463 00:17:14,414 --> 00:17:15,634 has provided benefits 464 00:17:16,575 --> 00:17:18,735 to some who have been overlooked in the 465 00:17:18,735 --> 00:17:20,894 labor pool in the past, but it's also 466 00:17:20,894 --> 00:17:21,394 created, 467 00:17:22,414 --> 00:17:23,235 high costs 468 00:17:24,174 --> 00:17:24,994 with diminishing 469 00:17:25,375 --> 00:17:25,875 reimbursement. 470 00:17:27,750 --> 00:17:29,930 And everyone is, struggling 471 00:17:30,630 --> 00:17:31,369 how to 472 00:17:32,150 --> 00:17:32,890 do more 473 00:17:33,269 --> 00:17:34,890 with an aging population 474 00:17:36,150 --> 00:17:37,769 and and serious challenges, 475 00:17:38,549 --> 00:17:39,769 to community health. 476 00:17:40,855 --> 00:17:42,474 We're we're looking at innovations 477 00:17:43,015 --> 00:17:44,855 in in the community settings as well as 478 00:17:44,855 --> 00:17:46,315 the hospitals, but, 479 00:17:47,335 --> 00:17:49,595 across the country, we see colleagues 480 00:17:50,294 --> 00:17:53,255 who are equally challenged. And and so that 481 00:17:53,255 --> 00:17:55,115 that continues to worry me. 482 00:17:56,240 --> 00:17:59,200 Absolutely. It's such a tough balance right now 483 00:17:59,200 --> 00:18:01,220 for hospitals and health systems 484 00:18:01,599 --> 00:18:04,079 across the board, especially as you mentioned, just 485 00:18:04,079 --> 00:18:06,339 so many pressures coming from, 486 00:18:07,279 --> 00:18:08,559 the workforce side, 487 00:18:09,039 --> 00:18:12,125 as well as financial challenges, trying to to 488 00:18:12,125 --> 00:18:14,684 navigate through. And so it's it it it's 489 00:18:14,684 --> 00:18:16,605 really great to hear, some of the things 490 00:18:16,605 --> 00:18:19,005 that you've been able to do, to continue 491 00:18:19,005 --> 00:18:20,605 providing care, but I can imagine, you know, 492 00:18:20,605 --> 00:18:22,384 some of these looming headwinds, 493 00:18:23,359 --> 00:18:23,859 certainly, 494 00:18:24,480 --> 00:18:27,440 can color how you're thinking about, building up 495 00:18:27,440 --> 00:18:29,359 programs and and, what you need to do 496 00:18:29,359 --> 00:18:31,460 in order to sustain success in the future. 497 00:18:33,920 --> 00:18:37,380 Absolutely. It's it's definitely exciting to work, 498 00:18:37,680 --> 00:18:38,180 and 499 00:18:38,595 --> 00:18:40,835 I would definitely say that the staff and 500 00:18:40,835 --> 00:18:41,414 the patients, 501 00:18:42,034 --> 00:18:43,974 give back much more than they receive. 502 00:18:44,994 --> 00:18:45,494 So 503 00:18:46,034 --> 00:18:48,054 if you enjoy the delayed gratification, 504 00:18:48,595 --> 00:18:50,819 there is gratification in this work. 505 00:18:52,099 --> 00:18:54,440 And, you know, I I would encourage, 506 00:18:55,380 --> 00:18:57,720 folks who at at times may be facing 507 00:18:57,779 --> 00:18:58,279 headwinds, 508 00:18:59,460 --> 00:19:00,759 to reach out to colleagues, 509 00:19:01,700 --> 00:19:03,159 go beyond your institutions 510 00:19:03,940 --> 00:19:04,679 to share, 511 00:19:05,664 --> 00:19:07,605 and, and then just consider 512 00:19:08,305 --> 00:19:11,125 some of the programs that that we use 513 00:19:11,904 --> 00:19:12,384 and, 514 00:19:12,945 --> 00:19:13,765 and investing 515 00:19:14,625 --> 00:19:15,525 in the well-being 516 00:19:16,065 --> 00:19:17,125 of your staff. 517 00:19:17,769 --> 00:19:20,009 It it's paid off for us, and, 518 00:19:20,410 --> 00:19:21,869 we're learning every day. 519 00:19:22,329 --> 00:19:24,670 The the work's tough, but it's very rewarding. 520 00:19:25,609 --> 00:19:27,849 Absolutely. Doctor Hackner, thank you so much for 521 00:19:27,849 --> 00:19:29,690 joining us on the podcast today. This has 522 00:19:29,690 --> 00:19:32,548 been, just a really fantastic conversation, and I 523 00:19:32,548 --> 00:19:34,568 look forward to connecting with you again soon. 524 00:19:34,948 --> 00:19:36,248 Thank you very much.