Hi, everyone. This is Lucas Voss with Beggars
Healthcare. Thanks so much for being here today.
It's great to have you. Today, we're going
to talk about elevating quality workforce and innovation
in health care. And I'm very excited to
be joined by Stephanie Mercado, CEO at the
National Association for Health Care Quality. Stephanie, thanks
for being here today. It's great to have
you. Thank you. I'm delighted to spend a
little bit of time with you this morning.
Absolutely.
If you could introduce yourself to our audience
and just share a little bit about your
work in health care.
Sure.
As you have already mentioned, I'm the CEO
of NACU, the National Association for Health Care
Quality. And I've spent, the better part of
twenty five years advancing my passion
and a really important agenda in health care.
My early career began with supporting,
physician organizations and really sort of sinking my
teeth in and understanding
the issues that are present in what I
would like to define as the front of
the house of health care.
And,
since working with NAICU, I've had the opportunity
to really dig into quality and safety and
finance and all of the administrative
complexities
of how the business of health care
is run. And, that's given me a really
great perspective
on what, I would call the back of
the house of health care.
So,
together,
both having experience in the front of the
house, in the back of the house, and
really just being super passionate
about advancing
quality and safety
and lowering health care costs
has been the the focus of my work.
I'm a a builder. I'm an innovator. I'm,
an approver,
and I think we can do better in
health care. I think we must do better.
And I also think that when we talk
about ways to do better,
we can really weave workforce into the mix.
And that's a very passionate focus here, not
only in my role, but at NAICU as
an organization.
Because as you well know,
the workforce is the biggest investment that we
make in health care. And I think that
people, our workforce,
can
really represent
the biggest impact
that health care can achieve as well.
Yeah. Absolutely. And I love that combination that
you just mentioned. Again, you get so much
experience. It's fantastic to have you on. I
wanna touch on the ROIQ
report, which, by the way, I recommend everybody
take a look at. Lots of incredible information
there. So the ROIQ report reveals
a really a powerful financial return from investments
in quality and safety, which is incredibly important.
Looking at that report, were there any findings
that stood out to you, and how's the
conversation around quality and safety shifting right now?
What are you seeing?
Yeah. In terms of,
findings that stood out, I'm I'm gonna give
a blanket statement, and I'm not trying to
take the easy way out, on this question.
But, honestly, it's it's the truth. What findings
surprised me?
All of them. And the biggest one being
that we could prove finally and sort of
once and for all Mhmm. That precisely
planned roles,
precisely
planned
functions in health care quality and safety,
and that a precision
targeted learning approach, a skilling approach, a coaching
approach
can demonstrably
impact quality outcomes
and improve the performance. And I'll tell you
what, nobody thought that this was possible.
And, to our knowledge, nobody's ever tried to
do this on the scale that we did
it,
which was really
about connecting workforce
to quality,
to safety,
and to finance. And I and I it
was amazing.
It's absolutely amazing.
And if I can, can I tell you
why this has been so elusive? Sure. Because
I've spent the better part of a decade
trying to figure out why we haven't figured
this out already.
I mean, I'm quite serious, but
but I but I think we, we we've
crossed the threshold, and we have, figured it
out, which is
so so quality has been really, really elusive
over the years and,
really seen as a compliance or a mandate.
And I don't think I think people sort
of conceptually thought you know, always thought it
was a good idea and conceptually thought a
lot of good things would come of it.
But there has been very little attention to
two things. One,
focusing on quality and safety on scale.
So
before we did this project, this program, this
workforce accelerator methodology that we created,
most organizations
were approaching quality and safety
on a project basis.
And I know you know this. Like, they
would go in and and focus on improving
sepsis,
reducing
falls, and many other things, and we absolutely
need to do that. But the the big
thing that no other
organization has kind of, like, developed methodology for
and that that few organizations have really achieved
outside of those who, you know, have worked
with us as early adopters of our workforce
accelerator program was to prove that we could
actually improve quality, safety, and finance
programmatically.
Like, we could we could do that across
the board for the entire
system.
So, yes, our projects involved in that, do
we wanna continue to improve,
on an item by item, initiative by initiative
basis?
Of course, we do. But we also now
know that it is absolutely possible and and
I think critical
that we do that on a system level
and program level improvement, and that's that's really
the basis of the ROIQ report, and what
we proved out is,
this is achievable, and there is a way
to do this effectively.
Yeah. You've mentioned sort of the elusiveness in
the beginning and trying to trying to find
it. What's been the industry response to this
report so far now that you've made that
connection?
The overwhelming response from the industry has been,
thank you, make you.
We are getting calls from
the public sector. We are getting calls from
the private sector,
and all of them are asking,
how did you do this?
What is the methodology
that you used
to improve quality and safety and finance on
this scale?
They're saying things like, we don't wanna play
whack a mole anymore. And we can we're
we have an untold amount of quality and
safety projects going on. I mean, I was
at a system the other day, and they
had a 150 quality projects going on.
Not to say that we don't need to
improve a 150,
you know, things, but
everybody is ready to scale. Right? They're ready
to stop playing whack a mole and to
come at this in an over the top,
sort of way.
And so the response has been absolutely overwhelming.
And and and and and and to the
point on the methodology, and they're asking, well,
what what's the how did you do this?
Like, tell us more. What's the one thing?
Right? Because our our ROI queue report actually
outlines five strategies.
But, in speaking, you know, with leaders at
CMS, they're like, but what's the one thing
that you did? And I said, the one
thing is is we developed
a methodology
to define what quality and safety is,
how to get your workforce aligned to that,
how to get them doing the right roles,
the right functions with the right skills at
the right time.
And we figured out a way to then
pull that through and measure it on quality
and safety and finance outcomes. So so the
the that methodology
that we have through our workforce accelerator program
is, like, the one thing. So the industry
has been excited, and I could just tell
you,
NAICU's board is excited about this. Our headquarters
staff is excited.
This is this is big news for the
industry, and we're so excited to be a
part of it.
Yeah. It's it's such an interesting report. Again,
I recommend everybody take a look at it
because it's it's fascinating to see that scalability
and to see that connection, which is important.
You've mentioned something, that is also very important,
which is the fact that it starts with
specializing folks, it starts with people, it starts
with with training, etcetera. And, again, the workforce
accelerator program emphasizes that up upscaling piece of
of teams and reducing variability across the board.
Can you touch a little bit on what
that looks like in practice
and how it then in turn really influences
outcomes?
Yeah. I sure can. And I I will
tell you, a couple things. So I'll tell
you broadly and then, or maybe, yeah, broadly,
and then I'll go a little deeper. So,
first of all, it is a somewhat complex
methodology
that we make simple. Right? Mhmm. So, there
is a whole sort of, twelve month process
that gets an organization
ready,
for this type of focus on quality and
safety. And then also,
prepares leaders to lead,
this initiative within their organization so that you
can come in and be an enabling force
for them. And,
also, that then guides them through our method,
which includes assessments and trainings and development and
coaching programs and communities of practice, like the
guided by a NICU navigator, which is a
a person who's who's sort of like, a
a coach,
for the systems to help get them set
up and situated for success.
But but what I will say,
outside of that sort of broad representation that
there is a program, it is robust, it
is effective,
I will tell you a couple things that
this program does.
So very practically,
I know everybody who's listening to this podcast
can relate to
this statement, which is quality is everyone's job.
Mhmm. And that is true. I believe that
wholeheartedly.
But before this workforce accelerator program was developed,
the industry had did not define what that
meant.
And so we were left with the ambition
to advance quality as everyone's role, but we
didn't actually have a way to do that.
And what I've observed too again, like I
said, I spent a better part of a
decade trying to figure out what we haven't
figured out and figured out how to solve
this problem yet. And and one of the
things that I've realized is that
health care as an industry has invested millions
of dollars,
probably
billions and billions of dollars
as an industry in training and development for
quality.
But
here's the here's the the punchline.
We've let learners
choose their own adventure in learning.
They choose how they're trained. They they decide
what courses to go to on their own
without any guidance, support,
or precisely
targeted
learning.
Or worse,
they they maybe are trained by a predecessor
who also also
learned their job
on
the job. And and and also,
we the as we've learned the the quality
competencies and skills through training and and, you
know, peer support,
we have focused so much and rightfully so
on quality and on safety.
But what we haven't done well enough
is communicate the financial return on investment,
which is particularly important right now when efficiency
is critical.
Not only because that is a priority of
the Trump administration,
but because it's the pathway for sustainable health
care. And so,
you know, I think this defining the roles,
targeting the learning, making sure that we connect
it to an ROI so that people understand
this is a worthy investment that pays
untold dividends,
for their organization,
I think is
really, really important,
and that there and most important is there's
a way to do it now. And and,
it's it's it's effective.
There's a pathway to it. I think that
that's really the one of the big keys
to it as well. And, again, the the
ROI piece you mentioned is so important, especially
from a leadership perspective, and you touched on
sort of the the programs that you have
in place for leaders to be able to
to fully take advantage of this too. Can
you touch a little bit more specifically on
that too in terms of how the workforce
accelerator
really benefits c suite leaders and and some
of the examples that you could share to
that really show that value for executives?
Yeah. Sure. And I'll, take us back as
a quick reminder too.
Quality is everyone's job. You know? That is
something so c suite is responsible for leading
the entire
operation
of health care where they work. And to
say quality is everyone's job, before and and
I think everyone everyone everyone believes that, But
that has been, elusive.
And now c suite have a concrete way
to make that actionable. Right? That's what the
workforce accelerator does. It takes the the guesswork
out of figuring out how to get their
teams ready
to be more high functioning.
Also,
we have made a lot of gains with
c suite, by helping them to understand how
to organize their workforce,
how to activate their workforce,
in ways that were previously complex. Like, we
have broken that down into a consistent,
reliable method, and we have made something that
is complex
simple. And we've done that with the Veterans
Health Administration. We've done that with Kaiser Permanente.
We've done that with CHRISTUS. All sorts of
organizations
who,
have followed the the workforce,
accelerator
methodology,
and we've proven that it works. And so
I think c suite right now, another thing
is they're looking for solutions,
and they they know that they need to,
you know, kind of, break the mold, be
creative,
try new
things. But the the challenge is is that
there's not a lot of tolerance for, risk
and failure. Right? Like, a lot of people
don't wanna put their neck out on the
line and say, you know, I have an
idea,
and then to not have it work out.
Nobody,
we don't have the time kind of,
luxury of time and money, that maybe we
thought we had before, to to, quote, unquote,
you know, waste on something that that may
or may not work. And so I think
for c suite, not only is the program
really focused on ROI, which brings a ton
of value to them as individuals to be
able to bring that forward to their organization,
but we've eliminated the risk associated with trying
a new program.
The not only we have NAICU, but so
did all the other leaders who implemented the
program, VHA,
Kaiser,
CHRISTUS.
All all sorts of organizations are listed in
our ROIQ report, and on our website.
They they've proven this out. They took the
risk, and, they've proven that NICU as an
enabling force with the workforce accelerator,
it it works. And so I think that
C suite can take comfort in knowing that,
there is a safe solution out there, for
workforce readiness and quality and safety.
Yeah. I love that you mentioned, again, that
risk factor. And and, again, like, time, we
don't have we don't have time. Right? It's
everything is about funding and ROI and and
risk. Right? What risks are we taking? What
risks are we not taking, etcetera? I think
this becomes especially important when you're looking at
organizations that might not have the resources. Right?
They're becoming even more concerned about where are
my investments going.
Can you touch a little bit on on
what programs or solutions are are particularly valuable
for some of those organizations that might struggle
with either smaller teams, right, smaller workforce, but
then especially also
limited resources?
Yes. A 100%. So we work with organizations
large and small, and I will tell you,
with a 100% confidence,
every single one of them, the biggest of
the biggest, the smallest of the smallest, the
the most immature organizations, and and the most
mature organizations
all struggle to some degree with,
activating quality and safety and finance. And and
it's real. You know? Each organization has a
different amount of resources. So a couple thoughts.
So one is, you know, we work with
smaller organizations.
We have worked with,
King's Daughter. We have worked with
El Paso Medical
Center. We have worked with Columbus Regional. These
are organizations on the smaller side,
of of system size. Right? Some single sites.
And,
we've worked with organizations I mentioned as big
as the Veterans Health Administration. So on this
on the small side,
the one huge thing that organizations could do
would be to help their, teams become CPHQ
certified.
So the CPHQ is the only
accredited certification in health care quality. It's NAICU's
certification
held by more than
15,000
individuals today and growing rapidly,
not only in The US, but around the
world.
And,
it's a wonderful program. In fact, the CPHQ
was endorsed
by the joint commission just this past November.
In fact, the joint commission has endorsed endorsed
NAICU's entire competency framework and is wildly supportive
of the ROIQ report and all of the
efforts we're doing to drive quality and safety
in health care.
So CPHQ is a great opportunity.
We also have a lot of other learning
resources,
available to people including,
a huge, event that both sort of,
rallies,
the the health care quality workforce and and
prepares them for what's next. It's called NAICU
next. So
that event is virtual. It's, very affordable, very
accessible. A few $100 per person instead of
hundreds or thousands for registration and travel and
flights and all the things. So we get
about 5,000 people a year to attend that
event in September.
And then, of course, you know, there's the
workforce accelerator program, which is,
you know, a a bigger commitment from an
organization,
but effective.
And and I I would say one more
thing, can I, which I I think this
is I think it's super important and worth
mentioning is, you know, we hear a lot,
especially from people working in quality departments, that
budgets were cut?
We're not doing discretionary spending.
Training is
on hold sort of thing.
And what I would say to that is
two things.
Number one, there's a ton of spending going
on in health care. Millions and billions and
trillions of dollars are being spent on health
care. So while there are cost pressures
that are absolutely real, and and I understand
them and I appreciate them,
People are choosing what to spend money on.
And and I think that it's important that
they choose to spend money on developing their
workforce
and having sustainable systems to not have this
whack a mole situation,
you know, going on in quality and safety
and health care,
for you know, as it is, oftentimes.
And I would also say too,
there is a return on this investment. So
it used to be
reasonable to sort of say, like, we don't
have money to spend on things like this
because, you know, there wasn't a an ROI
established, but now there is. And now it's
six and ten and twenty times the investment.
So I think that what we need to
get health care leaders to be doing and
people working in quality
is to get innovative and and brave and
bold and say, yeah.
Everything costs money in health care, but we
should be spending on the things and investing
on the things that are gonna return for
this organization,
return for our patients, and return for their
families. So large and small,
you know, mature and immature, there's all sorts
of organizations needing support, and all of them,
I think, you know, really need to commit,
to their workforce and to the outcomes and
to our patients. And this is a great
way to demonstrate that commitment.
Yeah. Absolutely. Again, proving the ROI, making that
financial connection, I think, is a great starting
point. Thank you so much for your time
and insights today. This was a fantastic conversation.
Thanks for being here.
Of course. I loved it. Thanks for the
opportunity. Yeah. It's great to have you. And
we also want to thank our podcast sponsor,
NAQ. You can tune in to more podcasts
from Becker's Healthcare by visiting our podcast page
at beckershospitalreview.com.