This is Laura Dirda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Danny Heckner, chief clinical officer at South
Coast Health System. Doctor Heckner, it's a pleasure
to have you on the podcast today.
A pleasure to be here, Laura.
Now I'm excited to have you as part
of this conversation because I know, we'll talk
about some of the cool things we're doing
at South Coast, particularly in looking at,
digital innovation and quality on technology side and
and delivering that into patients as well for
positive change. But before we dive into that
discussion, I'm curious. Could you tell us a
little bit more about yourself and your background?
Sure. I'm a Sears UCLA trained pulmonary critical
care physician,
still clinically active. I serve as chief clinical
officer of South Coast Health,
300,000
catchment
hospital system in Massachusetts,
but also serving, Rhode Island as well.
I currently hold the Goodspeed,
chair of quality of safety at South Coast
and also
serve as an associate professor at UMass Chan
Medical School. I served as one of the
core members of the road map to health
care safety in Massachusetts,
which was presented at the health care policy
forum
in April 23.
At the hospitals, your physician advisers may have
trained,
with the Compass PA program from the American
Case Management Association
that I helped develop.
And,
lastly, I'm trained in health care coaching through
the Health Care Coaching Academy.
The most important thing is I'm a Boston
Celtics
and LA Galaxy fan. There are not many
of those. A father of five and occasional
volunteer soccer coach.
Oh, it's fantastic to hear. And, you know,
I was curious. How did you become a
a a fan of both Celtics and LA?
Well, I originally came, with my family. My
dad,
was born in South Africa and and served
as a family doc, got interested in anesthesia,
and brought the family to Boston,
became
a a Celtics Red Sox fan at that
time. We eventually made our way to the
West Coast
and,
long time Galaxy fan,
with my kids,
and,
so pleased to see two championships
in the past year.
Yeah. Absolutely. That is super, super impressive and
a lot of fun. So,
really cool. Well,
thank you again for for jumping in here.
Could you tell us also as well a
little bit about what's driving quality and safety
journey that you're on at South Coast. How
are you thinking about the transformation?
So in my early career, I did work
at Cedars in the rollout of the core
measures in medicine,
and we developed point of care decision
support,
to augment very limited quality labor.
And at South Coast, we've been on a
very similar mission,
to drive real time clinical collaboration
within limitations,
that our current
market and and and and current,
staffing
require.
Using augmenting tech technology, we're really driving those
five core elements of the road map to
health care safety,
including leadership and safety culture,
operations that embed safety behaviors,
patient family and caregiver support,
workforce well-being,
and then a commitment
to measurement, measurement, measurement, and transparency.
Absolutely. I I think that makes a lot
of sense. And, you know, I really,
love that emphasis on being able to not
only elevate the safety aspect of it, but
then to have the measurement,
clear metrics and transparency as well.
How easy or or difficult is it to
make that transformation?
Obviously, the technology side is one thing, but
on the people side as well. I'm curious,
from your perspective,
what, have been helpful in how have you
kind of navigated the people side of this
type of transformation?
So in that first area, leadership and safety
culture,
we have to have sensitivity to operations.
We have to keep the walls up.
We we have to treat
throughput,
emergency access, primary access,
and
and specialty access as quality and safety issues.
And yet,
at the core of all of those operations
are human beings.
So it means,
really emphasizing
deference to those
human beings' experience, but also
their clinical expertise.
One of, you know, the key elements is
building strong dyadic tri triadic,
leadership.
So every every one of my clinical leaders
has an operations leader at their elbow,
and
and they they listen to the clinicians in
the field.
They listen to the front office staff, and
and together, you drive
operations
that that are are conscientious,
that are thoughtful.
And we've seen this really have a major
impact on on on experience scores.
We're running experience scores in our group in
the nineties.
I think primary care may be 89.
We're seeing,
well-being,
reported in our culture of safety,
surveys,
and we're seeing improvements even in hard hit
inpatient areas.
And it's great to see such positive results
there and truly, truly,
serving the community and patients in a meaningful
way.
I'm wondering, what are some of the digital
and quality technologies that have helped you accelerate
this positive change?
So South Coast marks its tenth year of
investing in EPIC and robust tools,
to enhance clinical care.
We're a premier client for our data warehousing
and benchmarking
capabilities. We're also an NRC client
for benchmarked
experience data.
Our visualization
platform is Tableau.
And then we've also adopt adopted some of
the needed elements,
such as Compass Rose for care navigation,
MyChart care companion,
which is very similar to other commercial products
for patient education and engagement.
But we also have an innovation arm called
Compodio that invests
that invests in educational and improvement technology
and also brings some of our innovation to
the market.
We're a level 10 CHIME most wired organization,
so we're very much committed to this nexus
of
of of people and technology.
You know, lastly, we have an AI center
of excellence.
It's recognized by American
College of Radiology.
We use AI
to manage cues,
never to diagnose
but to enhance throughput.
And,
and all of these
digital applications
together in a thoughtful way,
can, can make a difference.
Absolutely. That makes a lot of sense, and
I appreciate you outlining
some of the different,
technologies that have supported you through these journeys.
It's oppressive to hear, the level 10 chime
in in most wired recognitions as well as
the others from the American College of Radiology
in in other areas that,
truly, you know,
show how distinguished you are in the things
that you're doing at South Coast. That that's
really cool to hear.
In achieving or or making these achievements, how
has your team evolved throughout this journey?
Well, I'd I'd like to act, sort of
just,
you know, pull back the covers a little
bit and just explain,
before
how we apply the technology.
We have a fairly,
simple approach at at a high level.
So we like to combine,
available raw financial and operational data
together with,
processed
risk adjusted
data.
And we like to share it
across
our our organization from the board
to the front front
line.
And the way to do that is delivering
simple, meaningful visualizations
to staff
so they then have choice
and engagement,
understanding,
and then can decide on their test of
change. They can,
engage in idea generation.
They can
course correct,
and, most importantly,
internalize the improvement process.
So, you know, our organization and I believe
that health care personnel
are highly creative, and they're internally driven, but
it's our responsibility
to give them the tools, including the digital
tools.
As we've talked about earlier, it's really important
that we recognize the human factors,
and we have to find ways to
join robust process improvement
and agile workouts
with
an understanding
of the experience
of the providers and staff in the moment.
Folks have had probably one of the toughest
seasons in
in in seven years with with the flu
this this past winter. And
how can we, even during that really tough
season,
maintain and improve the experience of providers which
we have?
And and it's this combination
of attentiveness to
the the quality methodologies
and and the digital tools, but also
the experience of the individual in the moment.
You know, to do that, it sometimes requires
that we step back
as leaders
and
and allow
our teams and leaders
to innovate, to stub their toes.
Other times, we really should look beyond our
own institutions.
We've had wonderful collaborations with organizations
like the Betsy Lehman Center,
the CDC see difference collaborative,
our local public health officials,
such as our new New Bedford
and Fall River Public Health Leaders and and
then national organizations like NACCO, the National Association
of Community Health Officials.
And,
you know, sometimes leaders in a particular system
really need to just listen,
you know, outside of your own system and
and then bring in some of those best
practices
and and learnings.
So at South Coast, we're committed to making
a meaningful difference,
and it and and it involves,
really a lot of thoughtfulness,
but also
humility before the the data and the people.
So to really get to your question on
how the team has evolved
through this journey,
the team is really committed
to an open
and collaborative
as well as distributed approach
to improvement.
So
it it's a a normal practice at South
Coast to embed quality staff
in a clinical area,
such as
our top rated three star
cabbage
program and our wonderful structural heart program.
That quality staff is seen as part of,
the operation and, of course, can't do do
everything. That's where the dyadic,
triadic
relationships come into play.
And then
in areas where we've seen need, we've replicated
best practices
across disciplines and geographies.
So
when we saw an opportunity
with our wonderful nursing
staff to
develop professional practice
and simulation training and and a number of
other
elements,
we replicated
what may have been available,
to
to another part of our center or even
what was available outside our center.
So now, for instance, nursing peer review is
on par
with physician and HPAPP
peer review.
We've also developed and mentored leaders because
in some areas, folks just haven't had exposure
to
the challenge and, frankly, some of the mistakes
we've made in other areas and learned from
and and mentoring,
developing
leaders that are motivated
and and enjoy this approach
has really yielded wonderful
results.
In some cases, we've sent folks to
individual leadership training programs.
I've
I've had some success with the Harvard women's
leadership program,
and,
we've really turned the light on.
One of our hospitalist leaders,
did a wonderful AI program.
And, and so there are many
ways to mentor and develop
on both the technology side, but also
on on the human side.
And lastly,
you know, we've gotta flex
our our muscles in this area
even when events do not occur. And one
of the best ways to do that
and and to keep trained up is case
based learning.
So we do simulation training and case based
learning
with multidisciplinary
teams.
And,
and I do a very similar session at
the Harvard School of Public Health in the
summer,
for a day,
where we look at case based learning around
the leadership challenge.
And and these approaches within the health system
are very well received. You'll have a a
risk manager next to a quality nurse, next
to a professional practice peer review,
specialist,
next to a provider
physician
APP, next to an operations person,
and work through some challenging
events.
And we've dealt with issues such as workplace
violence, which
can be,
you know, can be dealt with in a
simulation
environment
quite safely,
but helps folks to prepare, helps folks to
address some of,
some of the challenges, but also some of
the opportunities.
That's great to hear. And and certainly,
such
a, important
aspects you're talking about here in in continuing
education and learning and how people can grow,
with new opportunities
as well as elevate themselves throughout their careers.
I'm curious before we wrap up here, what
are you most excited about for the next
year, and what makes you nervous?
Well,
I would say I'm very excited
about
our work on empathy training. We partnered with
a wonderful evidence based program, the company called
Empathetics,
doing a train the trainer
program rolled out to our hospitalists.
We learned from an organization on the West
Coast that,
did very well
with the program,
and, we're continuing to roll it out for
hospital based providers,
this winter
and spring.
I'm also very excited about our dementia work
with the guide program, and this brings folks
from
across the system,
ambulatory, inpatient,
home health, and and beyond.
We're including innovations from compodio.
We're using some new technology on AI language
and visual recognition,
and,
we're embedding it in our brain and spine
center, an ambulatory
memory clinic,
you know, that has, guide support.
And,
lastly, I'm very excited about
the overall journey
to high reliability,
you know, supporting,
our movement and our star ratings
and,
and and the well-being of
of our our staff and community.
What am I worried about in the coming
year?
Health care is really tough,
at this time. It's a market
that's quite disrupted.
On one hand,
increased
compensation,
for labor
has provided benefits
to some who have been overlooked in the
labor pool in the past, but it's also
created,
high costs
with diminishing
reimbursement.
And everyone is, struggling
how to
do more
with an aging population
and and serious challenges,
to community health.
We're we're looking at innovations
in in the community settings as well as
the hospitals, but,
across the country, we see colleagues
who are equally challenged. And and so that
that continues to worry me.
Absolutely. It's such a tough balance right now
for hospitals and health systems
across the board, especially as you mentioned, just
so many pressures coming from,
the workforce side,
as well as financial challenges, trying to to
navigate through. And so it's it it it's
really great to hear, some of the things
that you've been able to do, to continue
providing care, but I can imagine, you know,
some of these looming headwinds,
certainly,
can color how you're thinking about, building up
programs and and, what you need to do
in order to sustain success in the future.
Absolutely. It's it's definitely exciting to work,
and
I would definitely say that the staff and
the patients,
give back much more than they receive.
So
if you enjoy the delayed gratification,
there is gratification in this work.
And, you know, I I would encourage,
folks who at at times may be facing
headwinds,
to reach out to colleagues,
go beyond your institutions
to share,
and, and then just consider
some of the programs that that we use
and,
and investing
in the well-being
of your staff.
It it's paid off for us, and,
we're learning every day.
The the work's tough, but it's very rewarding.
Absolutely. Doctor Hackner, thank you so much for
joining us on the podcast today. This has
been, just a really fantastic conversation, and I
look forward to connecting with you again soon.
Thank you very much.