This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be join joined
by doctor Jose Azar, executive vice president and
chief quality and clinical service line officer as
well as professor of medicine at Hackensack Meridian
School of Medicine in the department of hematology
and oncology.
Doctor Azar, it's a pleasure to have you
on the podcast today.
Yes. A pleasure is mine, Laura. Thank you.
Absolutely. Now I'm excited to get into our
conversation. I know we're gonna be talking about
some really amazing things that you're doing there
at Hackensack Meridian Health,
connected to quality and patient safety and more.
But before we do, can you tell us
just a little bit more about yourself and
and the health system?
Yes. Absolutely. I am, as you mentioned, I'm
an oncologist by background. I've been, in the
quality and patient safety
arena for about
sixteen, seventeen years now,
and it's really a compliment to,
continuing the clinical work on a bigger scale,
and that's why I do that.
I've been with Hackensack Meridian Health for four
years since,
2022,
and it's been a really,
very rewarding,
ride.
So I'll tell you a little bit about
Hackensack Meridian Health. We are the biggest and,
most integrated
health system in New Jersey.
We have
18 hospitals,
500,
ambulatory care site locations,
40,000
amazing team members, and,
about 8,000,
physicians who are either
part of our medical group or affiliated,
with us.
So I get to work with all of
them, and that's,
that's a a truly deep honor for me.
That's amazing to hear. And, you know, what
an incredible organization. I know you've got a
huge size as well as influence in the
area. So it's exciting to see,
how you've been able to grow and develop
the,
department. Now I'm curious. Could you dig a
little bit deeper and tell us a bit
more about Hackesack Meridian Health's Agile Institute? What's
the mission, and how are you driving some
of the rapid quality improvement initiatives?
Yeah. Absolutely.
So we launched the Agile Institute,
two years ago.
And the reason we did that is because
in health care,
it can take sometimes up to seventeen years
to
implement
effectively
a, a new
discovery or a new,
treatment or a new health care solution.
And
to us, that's unacceptable. That's way too slow.
Health care needs to be transformed,
at a much faster rate. And at Hackensack
Meridian
Health, part of our mission and vision is
that transformation is in our DNA and innovation
is in our DNA. And
making health care
more accessible,
more affordable, and better for all patients
is definitely,
what we come to work to do every
day. And so in order to be able
to achieve that, we launched the Agile Institute,
which is
meant to,
support
our clinicians,
support our
clinical teams
in transforming health care and the way we
deliver care every day so that we can
better
serve patients
where they are and meet them
with their needs, whether in their communities, whether
they're in the ambulatory space, or whether they're
in our hospitals.
I'll tell you just,
in terms of its
foundation and and what it actually does.
The Agile Institute is based on
a transformation
and implementation
methodology
that,
we I developed with several of my colleagues.
And basically,
the Agile Institute delivers three services. It,
it trains people and changes culture,
so that we can adapt
a,
more of a startup
mindset.
Not waiting for a perfect solution, but really
testing a viable solution
in,
real time and then,
iterating and keep improving it,
as much as we can. So that's the
that's the first mission is to train and
change the culture.
The second is to provide and empower our,
bedside teams, our clinical teams, our
leadership with the tools
and the methods to effectively transform
and implement
a, evidence based solutions in health care.
So what is proven to work
should not take seventeen years to be implemented.
It should take
a very short time. We should,
be able to adopt
and drive that change very quickly. And then
the third part is
oftentimes, we don't have
proven solutions
and we cannot be paralyzed with that. We
need to innovate in real time and we
need to empower our bedside teams to be
able to do that. And we've created,
innovation units that allow us to test a,
a solution
very quickly. And once we find
that it works, we scale it as fast
as possible.
I
love that. I think it's so fascinating to
think about innovation, health care, and and now
moving so quickly because, traditionally,
health care has been a a bit slower
moving in for good reason. But, you know,
when when you talk about this culture change
and the shift that you're making in Hackensack
Meridian Health,
how do you do that? Because I think
that's something that hangs up a lot of
organizations and has been quite frankly a challenge
to try to, help clinicians and others understand
that moving quickly is important in finding those
areas where they can,
test different solutions in in real time,
figure things out that's really gonna be the
right space to do that type of innovative
work and then get used to moving more
quickly than they ever had done before?
Yeah. So
we do it with every single one of
our team members, and I think that's really
the key element that
innovation cannot be something we do on the
side. Transformation cannot be something we do on
the side. It should be
and and it is our mission and our
vision, and it is in our DNA.
And I think that that's where it starts.
Also,
our CEO,
mister Garrett,
and our leadership team
is very committed to innovation and transformation.
And I think that is
so critical that the leadership
is absolutely committed to supporting
innovation
in a very,
agile and adaptive way. Right? We we are
not afraid to make tough decisions.
We're not afraid to
test something
and figure out whether it works or not.
And we're not afraid to say, you know
what? There's a better way and a newer
way to do it. Let's figure out how
to,
spread it across
all of our hospitals or all of our
sites. And so that would be the the
second element.
And I think the, the third part in
terms of how we do it is we've
created a culture
that
fosters
innovative thinking,
that fosters psychological
safety so that
anybody
feels
comfortable to step up and say, hey, I
have a new idea, and they feel heard.
But
also, hey. I'm concerned
this may not be working.
And,
we take a pause and we listen to
that. And I think that's really critical. Because
otherwise, if you're trying
to transform
too quickly,
you could be reckless if you don't listen
to
the people who are actually doing the work
and allowing them to weigh in and and
and,
and direct your strategies
in a way that makes them effective.
Got it. That makes a lot of sense.
And, you know, I really appreciate that, kind
of additional context because I know the leadership
team often will have one idea and maybe
the frontline teams,
have another. And so having that type of
communication
and and balance between how you're looking at
innovative thinking, building it into the culture, and
then, you know, making sure that there is
that feedback,
between the two sides, it seems like it's
really critical.
Now I know that, the health system recently
received a five star,
rating from CMS and which is incredible. And
congratulations.
Could you talk a little bit about the
transformational changes that took place in order to
achieve this honor, and how did the team
work together cross functionally to make it happen
in such a short period of time?
Yeah. Absolutely.
But just to to,
be very accurate,
we have our flagship hospital, Hackensack University Medical
Center, is a five star hospital,
with,
you know, in the CMS ratings.
But all our hospitals now are three stars
or four stars and above. So,
that's, that's truly a transformation.
In the past
five years,
we have gone from
all our hospitals being great
to now we're moving our hospitals to being
all outstanding. And I'm I'm very, very excited
and very proud of all our our teams
because this really requires
each leader and each,
team member to be dedicated to excellence. And
that's what, that's what we fostered.
We fostered a culture where everybody is committed
to excellence,
and that's really what has helped
accelerate the transformation.
The other part to this is, we've partnered
very closely with our hospital leadership
across the entire network.
And,
we identified
and kept our focus on what are the
few things we can do that will have
the most impact.
And that's what we,
focused our attention on.
And then,
what we did is we kind of, we
empowered and unleashed the power of our,
bedside teams. So
we really
directed the teams to where the biggest opportunities
are and where we need to focus,
But then we also allow them to
come up with the solutions
and test those solutions. And once the solution
is working,
help disseminate it as fast as,
fast as possible.
We also are very mindful that health care
is
a business of people taking care of people.
And unless we have solution that are
designed by the people who are doing the
work
and that that are making their work easier
and more effective every day,
health care becomes too rigid and too slow.
And it loses its essence, which is
the the kindness, the caring,
the humane side of it. And that's what
we always anchor our solutions in.
We don't take solutions off the shelf
and try to force them.
We actually
partner with our team members to figure out
solutions that work
in real time in the real world.
That's helpful to understand. And, you know, I
I love how you're talking about making sure
that you're not forcing
those, solutions, but, you know, thinking of this
as a partnership and and making sure that,
you're able to go back and forth with
those bedside teams and and really taking the
heart everything that they're trying to do and,
their perspective on how these changes are going.
And, you know, I am curious,
when you look at the the idea of
taking care of people and being at the
bedside, is there any, example that you can
provide us of the change that you made
based on some of these,
different innovative,
innovation pushes that you've been doing or something
you've done at the suggestion of of a
bedtime bedside team member?
Yes. I'm gonna give you two examples,
that that really illustrate how we've
done a centralized
direction setting and strategy setting, but also
a decentralized,
bottom up type of solution finding
and,
performance improvement. So,
let me start by saying
we had to create
a structure that supports that.
So,
over the past several years,
we've always intended and wanted to,
hear from our team members, from our clinicians,
from our bedside
physicians, etcetera.
And
to be able to do that effectively,
we created,
what we're calling specialty collaboratives.
These are,
basically
groups of physicians
who,
are led by physicians
and they
we
we hand them problems and challenges we're facing.
And
they give us solutions, and they work with
us on implementing those solutions.
We organize those collaboratives by specialty because physicians
really
aggregate around their their specialty and what they
do on a day to day basis. So
we have a collaborative for internal medicine. We
have a collaborative for general surgery. We have
a collaborative for,
neurosurgery
or orthopedic surgery or neurology,
oncology,
cardiology,
pulmonology,
etcetera.
So,
these are physicians
in those specialties that come together on a
regular basis
to help us solve problems.
And we designed it in a very representative
way. So
every hospital sends us two physicians,
and
they send us one physician who is,
by specialty, basically. Two physicians, one that
is employed
and one that is, independent physician. Because
we love our physicians the same way, and
we value all our physicians the same way.
And we want to partner with all of
our physicians, whether they're independent or employed,
because they all bring,
tremendous value to problem solving and to improving
care at the bedside. So,
the way we designed it was similar to
the way, the senate is designed. Right? All
our hospitals are equally represented. And that was
very purposeful because
we care as much about our smallest hospitals
as our biggest hospitals and most complicated hospitals
because every single patient matters.
And from that perspective,
every clinician matters
in being able to bring, solutions. So that
specialty collaborative
model that is a representation
for all the hospitals equally,
for all of our clinicians equally, by specialty,
has helped us
be so granular in our problem solving. Right?
When we talk about,
improving care for patients with, let's say, congestive
heart failure,
we,
depend on our cardiologist to help us find
solutions.
We don't just bring a solution that's canned.
And that brings me to the second,
part of your question. So how did we
find solutions?
We listen to our physicians. Like, for example,
when when we were trying to improve,
readmissions and care for surgical patients,
our surgeons
brought up a a,
a new concept
that they wanted to pay attention to the
most vulnerable patient population
that they take care of, which is patients
who are older than 65 or 70.
And so
they wanted to,
establish a geriatric
surgery verification
certification. So, basically,
being certified that we provide
best evidence care to,
patients who are older than 65.
And the partnership was wonderful because they came
up with the idea. They knew what the
standards should be, but then we empowered them
with tools
and,
methodologies through the Agile Institute
to be able to
implement very quickly, test change very rapidly,
design those solutions in a way that,
makes sense to people,
and work,
in the real world
and are human centric.
And we were able to do this,
implement
and get the certification within a ten week
period of time. And that was a really
exciting,
you know, I I even get excited now
two years later,
and in terms of just thinking about how
quickly we were able to implement something,
that was
based on a direction that we set from
the network, which is, you know,
improving
certain outcomes,
a solution that came from the bedside and
from our, surgeons and our clinicians,
and then a method
that really helped bring it all together in
a very rapid implementation way. And that has
led to,
really great results. So you mentioned that
all our hospitals are three stars, four stars,
or five stars,
and that tells me we're
among the best in the country and definitely,
you know, the the best system in in,
in New Jersey
because of
that type of partnership
and effective,
implementation of best best practices.
Absolutely. And that's amazing. You know? And I
I really appreciate you digging that one level
level deeper because,
you know, that implementation side of it truly
is a a huge unlock and and being
able to see success there and moving quickly,
is critical.
Now looking into 2026, where do you see
some of the big priorities or headwinds that
you're focused on right now?
Yes. You know, with with all the improvements
that we've made, I feel very confident that
we're providing outstanding care
for every patient that we take care of.
The
challenge and the headwind that we're facing is
that
not every patient can access our care.
And I think access to health care and
access to high quality care
is a very, very important responsibility for all
of us.
It doesn't matter if I have the best
care in the world and only a few
people can access it.
My communities
and
the,
the communities that we serve, the communities we
live in,
the people that we're supposed to help
are gonna suffer if they can't access the
outstanding care that we have. And so this
is where we're putting a lot of our
focus in 2026
and beyond, is to think about designing our
care models,
meaning organizing the way we deliver care
in a way that allows for very rapid
access.
Same day access,
same week access,
and no more than, you know, access within
two weeks to a highly subspecialized
service. That's what we're really aiming towards.
We want to be able to see you
when you need to be seen,
and we we need need to be able
to rethink the way we organize ourselves
so that we can meet that expectation and
that responsibility, honestly, that we have to
our patients and our communities.
I think that access question is critical and,
you know, looking into these innovative solutions and
the things, you know, that you've been doing,
on the culture side to be transformational.
It seems to set yourself up,
for success in, you know, troubleshooting some of
those challenges, which, you know, are industry wide.
I'm curious. What do you think the hardest
thing you'll have to do in the coming
year will be?
You know, designing the care models and rethinking
the way we
we organize ourselves is gonna be difficult because
let's face it. I lead change and change
is kind of, you know, my job and
my responsibility.
I don't like change. I have to change,
but I don't like change. And I think
winning the hearts and minds of our clinicians,
and engaging them very early on so that
they are part of the change and the
change is not happening to them, So that
they are designing those care models and they
are helping
us figure out how to best meet those
access standards
rather than doing it to them. We wanna
do it with them.
And we also wanna engage
our patients in our communities to understand
what are they expecting of us and what
do they need from us,
so that we can factor that into our
care model design. I would say that's our
biggest challenge, but also to me, that's our
biggest exciting opportunity.
Figuring out how to do that and how
to do it quickly
is gonna be really,
challenging, but also really, really exciting and very
meaningful.
I also think that
with all the
AI technology and all the advances in artificial
intelligence,
I think we're gonna be able to also
accelerate our ability to
imagine and execute on a
new and better future where access becomes
an engaging,
term rather than a frustrating term.
Absolutely. That that would be, you know, an
amazing transformation to see. And when you look
at access, when you look at technology,
how does that show up for Hackensack Meridian
Health? What are the ways that you are
leveraging or or plan to leverage technology to
expand some of those access points?
Well, I think we need to meet people
where they are. And I think technology
helps
us do that in a couple different ways.
One,
you know, and most straightforward is,
using
AI agents to help interact with patients
on demand when they need to be interacted
with. And we're already using AI agents to
help us with,
scheduling, to help us,
with navigating patients through our system.
So we wanna expand on that.
That digital interaction is is really critical.
The other way is,
leveraging
AI technology
to better
understand
our gaps, our opportunities,
and really model
to better model our our care in a
way that is,
responsive to our patients. So being able to
use technology for better analytics
and for better
testing of change
in a virtual way that allows us to
figure out
and,
and modify,
before we implement
is, is gonna be really critical.
So both in the interface with patients, but
also on the back end,
in the analytics,
and in the,
predictive modeling.
Got it. That's helpful to understand. Now before
we wrap up here, where do you see
some of the best opportunities for organizational growth?
Well,
I'm gonna build on access because if we
have an engaging
and timely access for every patient, we can
meet them where they are.
We can navigate
their journey and their experience through our health
system
to give them access to the best care
that we already deliver.
I think that's gonna
lead to tremendous growth,
in our,
ability to serve our communities and our patients.
I think the other area of growth,
is not necessarily in terms of business growth,
but really
in terms of our capabilities
growth.
Very, very soon,
we're all gonna have to face a very
real
change in our,
day to day life. We're either gonna be
enabled by AI or we're gonna be, you
know, pushed to the side by AI.
And at Hackensack Meridian Health, because we are
absolutely committed to innovation
and to transformation,
we're embracing AI as a a technology that's
gonna enable and empower our workforce
and our, team members
to
be the best caregivers they can ever be,
to be able to achieve things that they've
dreamt of in terms of interacting with patients
and,
being able to serve patients better.
And that to me is really exciting.
I love it. Doctor Azar, thank you so
much for joining us on the podcast today.
This has been such a fun conversation, so
informational and inspiring to hear about what you've
been doing at Hackensack Meridian Health. And, you
know, I look forward to connecting with you
again soon. Yeah. Thank you very much. Thanks
for taking the time.
Absolutely. And, you know, I am excited to
see you as well at our annual meeting
coming up in April. I know you'll be
a speaker on one of our panels, and
it'll be a truly great opportunity to connect
it and, talk further on some of these
things that we've mentioned today. So looking forward
to that too. To that. Yeah. I'm looking
forward to that as well.