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The most important health care decisions don't happen

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in isolation.

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They happen when leaders come together.

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Becker's sixteenth annual meeting brings together more than

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3,500

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hospital and health system executives this April in

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Chicago.

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With 800 speakers from Ascension,

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Cleveland Clinic, CommonSpirit and more, the conversations get

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real. Leaders will share how their scenario planning

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for policy shifts, breaking through value based care

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barriers, and building clinical teams that translate

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event

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details,

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visit beckershospitalreview.com

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and click on the events tab in the

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upper right.

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This is Laura Dirda with the Becker's Healthcare

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podcast. I'm thrilled today to be joined by

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doctor Mada Nitsu, who's the vice president and

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chief medical officer at Indiana University School of

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Medicine and O'Reilly Children's Health. Doctor Nitsu, it's

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a pleasure to have you on the podcast

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today.

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My pleasure is mine.

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Fantastic. Well,

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I'm excited for our conversation because I know

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there's so much happening at IU Health, and

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it'll be really truly amazing to hear some

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of the cool things you've been doing over

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the last year as well as how you're

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thinking about the future. But before we dive

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in, can you tell us a little bit

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more about yourself and Riley Children's Health?

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Oh, absolutely. So,

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I have

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been serving as a chief medical officer at

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the Riley Children's Health for the last three

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years, but I, have been a physician here

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in,

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this institution for twenty five years of my

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career

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and,

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have

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enjoyed every single moment.

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Fantastic. You know, that's, amazing career you've had

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there. And when you think about especially the

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last year or so, could you tell us

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about initiative that you led? What did you

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do, and what were the results?

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The biggest,

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buckets of areas that we are focusing

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on at the moment are,

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care coordination and access to care for for

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all patients,

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and

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improving quality

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specifically by eliminating

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hospital acquired harm.

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If,

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I am to focus on the

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latest one of the two projects, We've been

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very successful in reducing hospital acquired harm.

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And, specifically,

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as an example, for the CLABSI, for the

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central line associated line infection,

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we were able to decrease the infections,

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to a standardized

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infection rate

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of point five one, which has been the

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best we've

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been able to perform,

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for,

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ever since 2019.

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So,

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very, very happy to see that

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we are gaining those outcomes.

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Well, that's amazing to hear. And, you know,

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when you look at that type of,

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outcome, that transition and being able to really

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reduce that hospital,

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acquired harm,

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What did you how did you,

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change the mindset in processes and workflows? What

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did you do on the,

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clinician and clinical level

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to achieve those results?

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It takes a village,

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as you as you are suggesting with your

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question.

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And,

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really hardwiring,

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high reliable

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organization,

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high high reliable

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mindset

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takes a number of interventions. So I would

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say the most successful

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first

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step was creating

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a hack committee, which,

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stand for hospital acquired condition committee.

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And we have

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we have asked a leader, a diet, a

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physician,

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nurse diet leader

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to lead each one of these hack committee.

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And we have one for central line associated

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infection, one for

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catheter associated urinary tract infection, one for,

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accidental

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unplanned extubation,

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and so in medication errors and so on

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and so forth. So every single one of

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the hospital acquired conditions harm,

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get a hacked committee.

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And then underneath those team leaders,

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we've built up

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teams from the,

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participants

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from the main areas that would be at

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higher risk to acquire those infections.

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And this is

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a systematic way to

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build make sure that we are adhering to

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the standards of nursing practice that that are

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the standard of care that are

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well accepted, the bundle of care, and

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then continue to,

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improve the high reliability

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there and really

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patient with failure. And, moving from reactive to

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predictive has been

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probably the biggest accomplishment that led to those

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outcomes.

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That's helpful to understand and, you know, definitely,

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seems like that systematic process and then having

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the dyad leaders come together and, really be

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accountable for those outcomes makes a big difference.

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That's really cool to hear.

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Now looking ahead,

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what are some of the big priorities and

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headwinds that you're focused on for 2026?

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I think the biggest priority will will be

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to continue to

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to work on the heart prevention, but we

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are,

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doubling down on,

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optimizing

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access care coordination

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and,

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really

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throughput and length of stay.

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With the Medicaid reform, we are,

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expecting that,

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payment model is going to,

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be restructured. And with that, we we are,

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preparing we are working very hard to adapt

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to the new model and to be able

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to become even more efficient in the way

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we move patients through the continuum. We focus

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a lot on the length of stay and

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readmission. We definitely would not want to discharge

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patients sooner than they already, such that we

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have more readmission.

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But just in time,

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it's

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what we are focusing through. So really access

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and throughput would be probably the biggest priority

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for this year.

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That's helpful to understand. And I think especially

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through the lens of some of those changes

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that are coming down the pipe with insurance,

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Medicaid reform, and other areas that could be

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challenging

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to for for folks to access care in

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the way they used to.

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And so, you know, when you're thinking about

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access,

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in general, and

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I I know we touched on a little

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bit, obviously, traditional access points as well as

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looking at, you know, digital and more.

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What does it take for the system as

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well as clinicians,

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on their level to, really think differently and,

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be ready,

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to make the necessary adjustments so that patients

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can still have access to the care that

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they need?

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It's a very good question,

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and it's a multifaceted,

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effort that needs to be put in place.

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I think the biggest

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point for the physician is to be able

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to have to to to to be certain

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that the patient has the ability to receive

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the care that they need

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outside of the hospital and specifically the follow-up.

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We've put together on

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a number of,

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different models that are looking to the most

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complex patient discharges,

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particularly for those who live very far away

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from our institution because, obviously, we serve the

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entire state of Indiana and and beyond.

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And a lot of our patients travel two

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to three hours to to come to our

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institution. So discharging

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one patient like that poses more challenges

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than one who would be right next door,

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lock located in you know, close by the

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by our facility.

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And,

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just, we've put together models in which sometimes

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we discharge the patient to a nearby,

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for just for a night or so for

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the family to feel comfortable to do so.

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Or we do a lot of patient care,

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parent care,

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in the hospital prior to discharge, working with

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the home,

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care,

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organizations to make sure that the family receives,

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at home the the help and the support

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that they need.

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So it there is a lot of care

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coordination

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that gets packaged behind these,

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these these charges that is very, very important

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to get it right.

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That makes a lot of sense. Thank you

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for digging a little bit deeper there. Now

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what do you think the hardest thing you'll

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have to do in the coming year will

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be?

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The hardest thing? I really think getting this

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done right is not easy.

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And then,

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if I want to dive a little bit

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deeper in this, it's probably the behavioral health

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and the care coordination in that patient population.

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And I think that's difficult solely because,

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of the increasing

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epidemic that we see with behavioral health and

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the fewer resources that are available within health

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care for those patients.

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So how do we wrap our mind

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around supporting the patients who have an added

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layer of complexity that comes from behavioral health

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standpoint? It's

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it's,

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one area in which we will need to

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partner with the entire community to be able

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to deliver that because partnering with the schools,

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partnering

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with all resources

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is going to be crucial

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to to be able to develop a model

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that's sustainable.

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That makes a lot of sense. I I

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think, you know, it's so difficult to try

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to understand all the dynamics coming into behavioral

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health and where it can actually make the

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biggest impact when you're looking at the population,

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when you're looking at how you want to

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not only improve outcomes, but also make sure

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that you're running the system efficiently on the

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operational and financial side. So I think that's

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a huge,

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challenge and question for so many leaders across

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the country. And,

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you know, I can imagine from your seat

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too, in in being,

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focused very much on on the patients and

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the outcomes,

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you know, it takes a lot of work

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and coordination,

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and connection with your executive team to make

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this happen.

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Yeah. And,

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if I may add

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to that particular point,

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one

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physical space we are developing as we speak,

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and, hopefully, we are going to go live

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with it by midyear

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twenty twenty six,

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is

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a, medical

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behavioral

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health unit.

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What that is is a unit in which

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patients who have behavioral health needs are going

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to be admitted,

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but in addition,

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they would also have medical medical,

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care needs.

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Because currently, those patients are admitted in the

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regular medical floor, and they don't have access

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while they receive medical care. They don't have

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access to the behavioral health programming.

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So we are building a unit that is

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going to be able to deliver both aspects

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of care in the same time.

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And,

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would be one of the

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few such units in the country, and we

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are partnering and learning from those who have

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one that's already established

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to see how to launch it to make

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it safe and effective.

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Absolutely. I think being able to learn from

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others is always a really,

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important,

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aspect of health care and partnering on a

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deeper level,

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especially now more than ever is critical.

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Now before we wrap up, I want to

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ask you about growth as well. Where do

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you see some of the best opportunities for

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organizational growth going forward?

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The biggest growth opportunities that we see are

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in,

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improving access. We we have

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a lot of patients who are

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hoping to receive care from our organization, but

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our access, meaning the time that one needs

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to wait to get an appointment in the

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outpatient space,

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sometimes doesn't meet the needs of the family.

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So trying to think of, creative model to

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optimize that and then make sure that we

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are meeting the family needs in terms of,

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providing fast and prompt and effective care for

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those families, it's one of the opportunity. The

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other opportunity is,

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in the area of creating new models of

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care. So,

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a lot of work is being done in

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terms of,

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programs of national excellence and creating those destination

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programs in which,

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the entire team is focusing and thinking about

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that particular condition,

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and,

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brings innovation in the way we are treating

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the patient. So I think,

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being able to be at the innovation

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side of things in terms

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of complex conditions and patients with,

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orphan illnesses or even illnesses that are frequent

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enough but require more of a care coordination

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is one side of things, and the other

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is just access for all and being able

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that we meet the needs of the patients

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and the families in terms of getting them

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in.

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Absolutely.

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Access access access is such a huge it

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seems like theme of the year,

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across the board. And so, you know, to

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understand in a a better way how you're

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thinking about that and finding those creative models

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and and problem solving, in real time is

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just really cool to hear. Thank you so

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much for joining us on the podcast today,

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doctor Ninsu. It's been such a fun conversation.

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I I've learned a ton and look forward

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to continuing,

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our conversation as well at the annual meeting.

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I know you'll be speaking on a panel

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there, and, it'll be truly fantastic to hear

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from you and, just continue to learn more.

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Thank you so much for your time, Laura,

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and I've enjoyed having this conversation with you

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as well.