The most important health care decisions don't happen
in isolation.
They happen when leaders come together.
Becker's sixteenth annual meeting brings together more than
3,500
hospital and health system executives this April in
Chicago.
With 800 speakers from Ascension,
Cleveland Clinic, CommonSpirit and more, the conversations get
real. Leaders will share how their scenario planning
for policy shifts, breaking through value based care
barriers, and building clinical teams that translate
event
details,
visit beckershospitalreview.com
and click on the events tab in the
upper right.
This is Laura Dirda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Mada Nitsu, who's the vice president and
chief medical officer at Indiana University School of
Medicine and O'Reilly Children's Health. Doctor Nitsu, it's
a pleasure to have you on the podcast
today.
My pleasure is mine.
Fantastic. Well,
I'm excited for our conversation because I know
there's so much happening at IU Health, and
it'll be really truly amazing to hear some
of the cool things you've been doing over
the last year as well as how you're
thinking about the future. But before we dive
in, can you tell us a little bit
more about yourself and Riley Children's Health?
Oh, absolutely. So,
I have
been serving as a chief medical officer at
the Riley Children's Health for the last three
years, but I, have been a physician here
in,
this institution for twenty five years of my
career
and,
have
enjoyed every single moment.
Fantastic. You know, that's, amazing career you've had
there. And when you think about especially the
last year or so, could you tell us
about initiative that you led? What did you
do, and what were the results?
The biggest,
buckets of areas that we are focusing
on at the moment are,
care coordination and access to care for for
all patients,
and
improving quality
specifically by eliminating
hospital acquired harm.
If,
I am to focus on the
latest one of the two projects, We've been
very successful in reducing hospital acquired harm.
And, specifically,
as an example, for the CLABSI, for the
central line associated line infection,
we were able to decrease the infections,
to a standardized
infection rate
of point five one, which has been the
best we've
been able to perform,
for,
ever since 2019.
So,
very, very happy to see that
we are gaining those outcomes.
Well, that's amazing to hear. And, you know,
when you look at that type of,
outcome, that transition and being able to really
reduce that hospital,
acquired harm,
What did you how did you,
change the mindset in processes and workflows? What
did you do on the,
clinician and clinical level
to achieve those results?
It takes a village,
as you as you are suggesting with your
question.
And,
really hardwiring,
high reliable
organization,
high high reliable
mindset
takes a number of interventions. So I would
say the most successful
first
step was creating
a hack committee, which,
stand for hospital acquired condition committee.
And we have
we have asked a leader, a diet, a
physician,
nurse diet leader
to lead each one of these hack committee.
And we have one for central line associated
infection, one for
catheter associated urinary tract infection, one for,
accidental
unplanned extubation,
and so in medication errors and so on
and so forth. So every single one of
the hospital acquired conditions harm,
get a hacked committee.
And then underneath those team leaders,
we've built up
teams from the,
participants
from the main areas that would be at
higher risk to acquire those infections.
And this is
a systematic way to
build make sure that we are adhering to
the standards of nursing practice that that are
the standard of care that are
well accepted, the bundle of care, and
then continue to,
improve the high reliability
there and really
patient with failure. And, moving from reactive to
predictive has been
probably the biggest accomplishment that led to those
outcomes.
That's helpful to understand and, you know, definitely,
seems like that systematic process and then having
the dyad leaders come together and, really be
accountable for those outcomes makes a big difference.
That's really cool to hear.
Now looking ahead,
what are some of the big priorities and
headwinds that you're focused on for 2026?
I think the biggest priority will will be
to continue to
to work on the heart prevention, but we
are,
doubling down on,
optimizing
access care coordination
and,
really
throughput and length of stay.
With the Medicaid reform, we are,
expecting that,
payment model is going to,
be restructured. And with that, we we are,
preparing we are working very hard to adapt
to the new model and to be able
to become even more efficient in the way
we move patients through the continuum. We focus
a lot on the length of stay and
readmission. We definitely would not want to discharge
patients sooner than they already, such that we
have more readmission.
But just in time,
it's
what we are focusing through. So really access
and throughput would be probably the biggest priority
for this year.
That's helpful to understand. And I think especially
through the lens of some of those changes
that are coming down the pipe with insurance,
Medicaid reform, and other areas that could be
challenging
to for for folks to access care in
the way they used to.
And so, you know, when you're thinking about
access,
in general, and
I I know we touched on a little
bit, obviously, traditional access points as well as
looking at, you know, digital and more.
What does it take for the system as
well as clinicians,
on their level to, really think differently and,
be ready,
to make the necessary adjustments so that patients
can still have access to the care that
they need?
It's a very good question,
and it's a multifaceted,
effort that needs to be put in place.
I think the biggest
point for the physician is to be able
to have to to to to be certain
that the patient has the ability to receive
the care that they need
outside of the hospital and specifically the follow-up.
We've put together on
a number of,
different models that are looking to the most
complex patient discharges,
particularly for those who live very far away
from our institution because, obviously, we serve the
entire state of Indiana and and beyond.
And a lot of our patients travel two
to three hours to to come to our
institution. So discharging
one patient like that poses more challenges
than one who would be right next door,
lock located in you know, close by the
by our facility.
And,
just, we've put together models in which sometimes
we discharge the patient to a nearby,
for just for a night or so for
the family to feel comfortable to do so.
Or we do a lot of patient care,
parent care,
in the hospital prior to discharge, working with
the home,
care,
organizations to make sure that the family receives,
at home the the help and the support
that they need.
So it there is a lot of care
coordination
that gets packaged behind these,
these these charges that is very, very important
to get it right.
That makes a lot of sense. Thank you
for digging a little bit deeper there. Now
what do you think the hardest thing you'll
have to do in the coming year will
be?
The hardest thing? I really think getting this
done right is not easy.
And then,
if I want to dive a little bit
deeper in this, it's probably the behavioral health
and the care coordination in that patient population.
And I think that's difficult solely because,
of the increasing
epidemic that we see with behavioral health and
the fewer resources that are available within health
care for those patients.
So how do we wrap our mind
around supporting the patients who have an added
layer of complexity that comes from behavioral health
standpoint? It's
it's,
one area in which we will need to
partner with the entire community to be able
to deliver that because partnering with the schools,
partnering
with all resources
is going to be crucial
to to be able to develop a model
that's sustainable.
That makes a lot of sense. I I
think, you know, it's so difficult to try
to understand all the dynamics coming into behavioral
health and where it can actually make the
biggest impact when you're looking at the population,
when you're looking at how you want to
not only improve outcomes, but also make sure
that you're running the system efficiently on the
operational and financial side. So I think that's
a huge,
challenge and question for so many leaders across
the country. And,
you know, I can imagine from your seat
too, in in being,
focused very much on on the patients and
the outcomes,
you know, it takes a lot of work
and coordination,
and connection with your executive team to make
this happen.
Yeah. And,
if I may add
to that particular point,
one
physical space we are developing as we speak,
and, hopefully, we are going to go live
with it by midyear
twenty twenty six,
is
a, medical
behavioral
health unit.
What that is is a unit in which
patients who have behavioral health needs are going
to be admitted,
but in addition,
they would also have medical medical,
care needs.
Because currently, those patients are admitted in the
regular medical floor, and they don't have access
while they receive medical care. They don't have
access to the behavioral health programming.
So we are building a unit that is
going to be able to deliver both aspects
of care in the same time.
And,
would be one of the
few such units in the country, and we
are partnering and learning from those who have
one that's already established
to see how to launch it to make
it safe and effective.
Absolutely. I think being able to learn from
others is always a really,
important,
aspect of health care and partnering on a
deeper level,
especially now more than ever is critical.
Now before we wrap up, I want to
ask you about growth as well. Where do
you see some of the best opportunities for
organizational growth going forward?
The biggest growth opportunities that we see are
in,
improving access. We we have
a lot of patients who are
hoping to receive care from our organization, but
our access, meaning the time that one needs
to wait to get an appointment in the
outpatient space,
sometimes doesn't meet the needs of the family.
So trying to think of, creative model to
optimize that and then make sure that we
are meeting the family needs in terms of,
providing fast and prompt and effective care for
those families, it's one of the opportunity. The
other opportunity is,
in the area of creating new models of
care. So,
a lot of work is being done in
terms of,
programs of national excellence and creating those destination
programs in which,
the entire team is focusing and thinking about
that particular condition,
and,
brings innovation in the way we are treating
the patient. So I think,
being able to be at the innovation
side of things in terms
of complex conditions and patients with,
orphan illnesses or even illnesses that are frequent
enough but require more of a care coordination
is one side of things, and the other
is just access for all and being able
that we meet the needs of the patients
and the families in terms of getting them
in.
Absolutely.
Access access access is such a huge it
seems like theme of the year,
across the board. And so, you know, to
understand in a a better way how you're
thinking about that and finding those creative models
and and problem solving, in real time is
just really cool to hear. Thank you so
much for joining us on the podcast today,
doctor Ninsu. It's been such a fun conversation.
I I've learned a ton and look forward
to continuing,
our conversation as well at the annual meeting.
I know you'll be speaking on a panel
there, and, it'll be truly fantastic to hear
from you and, just continue to learn more.
Thank you so much for your time, Laura,
and I've enjoyed having this conversation with you
as well.