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This is Chris Sosa with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Mary Si,
vice President of Primary Care at Children's Hospital of Wisconsin. Mary,
thank you for joining us today.
Oh, you're very welcome, Chris. Thank you for the opportunity.
Could you please introduce yourself and tell us a bit about your background?
I'd be happy to. So, I'm Mary Si.
I serve as Vice President for the primary care division at
Children's Hospital of Wisconsin in Milwaukee. Um, my background, I,
I have a bachelor's degree in nursing and an MBA and my
career has been in pediatrics for over 30 years. Um,
and also a life leadership coach. I started in my first leadership role,
um, in operations, in ambulatory specialty,
and then really have been very fortunate to,
to be able to kind of move around the organization.
I've worked inpatient care for a period of time,
and then I shifted into leadership roles in strategic management
and business development, and now for the last eight years,
have been backing operations for our primary care division,
and that includes, um,
urgent care services and our children's medical group.
And in round numbers we have about 150 pediatricians
and around 500 employees that provide primary and urgent care
services in over, uh, 20 locations across southeast Wisconsin.
What do you think led to your shift to leadership?
Oh, that's a good question. I think for me it was, um,
recognizing I always had a, uh,
desire to analyze things as they are and see how they could be better.
And so as I shifted from nursing,
I think my probably first foray that was, um,
just looking at quality within healthcare and, um,
starting out as a member of a quality committee and, um,
recognizing the impact that happens when you step out of the
business for a period of time to analyze what you're doing so that you can
improve what you're doing in the business.
And so I think that's how I would describe, um,
how I think about leadership and how I navigated my way there.
Terrific. Mary, what would you say are your top priorities today?
Well, they really fall under,
I would say two broad categories of attention and they're equally important.
Uh,
the first is really making sure our providers and teams have what they need
to do and really be their best. Um, you know,
I think workforce stabilization has been a big priority
in healthcare, uh, over the last couple years.
Our vacancy rates have stabilized and we've done that with some really novel
pipeline programs for all our roles in the care team, uh,
including front desk, our medical assistant and our nursing roles.
And so now we're kind of really shifting to added
attention in, in advancing professional growth and development.
So things like redesigning orientation and onboarding
and our preceptor program,
really understanding our current workforce and
supporting employees to be able to advance along that
novice to expert continuum and reinforce the
sense of purpose in the work and engagement in the organization.
Um, so that's, that's one thing. And definitely wellbeing plays into that. Um,
we've had significant attention in supporting wellbeing.
We really, prior to the pandemic, um,
children's has a very strong foundation of culture, um,
called at our best and at our best together,
and included in that is our value of health for ourselves and for
each other. So, you know, post pan,
fortunately we had that value and it was very strong.
I think it helped us as an organization get through the pandemic and
now post pandemic, we've really augmented that with, uh,
on our team with a training in trauma-informed care.
And the intent of that was not only to gain a greater understanding
of the impact of trauma on families we serve,
but also acknowledging how we support each other and enhance our own resiliency.
So that's been part of it. Definitely. Um, you know,
tied into that, uh, workforce strategy is leadership presence,
rounding with our teams, and then additionally,
um,
recognizing that how important it is for our team
members to have a sense of community and particularly within the roles
that they fulfill in the clinics.
So we've had opportunities for all of our different roles,
the front desk role, our advanced practice nurses,
um, and PAs, our, uh, MAs to come together,
network share feedback,
and generate ideas on where we can improve. And that has really,
for a team that is spread out across 20 locations,
it has broadened that sense of community within those specific roles
and given them, uh, a place to network and learn.
So that's the workforce piece of it.
I think the second is really responding to the evolving needs that our
families are having. So those needs are evolving,
and we're really trying to look at how we do that in a way that's not only
efficient for the care team,
but also provides an efficient experience for families. So, you know,
primary care is where caregivers go for guidance and reassurance
as they kind of navigate the milestones of childhood.
And so our parents really speak of their pediatrician as one of the most
important relationships they've had. And, um,
I always talk about the care that's provided by our pre pediatricians
falls into three areas, preventive care, acute care,
and then chronic conditions such as asthma and ADHD.
And so when we're as committed as we are to providing the very best across all
those areas, we have to look at multitude of things.
So ease of access to care is one thing right now.
I think convenience is such a significant factor in how families
think about accessing care,
enhancing the service and experience in the actual visits.
One of the most significant investments we've made has
been in providing mental health services.
So our pediatricians we're seeing in increase in mental health
concerns prior to the pandemic. And we at that time were, um,
increasing existing services in response.
And now with the exponential needs post pandemic,
we have completely transitioned to an integrated preventive behavioral
health healthcare model in all of our clinics.
And this is with licensed therapists as part of the provider team. Um,
the model is very intentional to not only address the
current high demand for acute mental concerns,
but also providing Prevental health across all age groups.
So our therapists are introduced to families in our preventive well visits,
and it's regardless of whether there's a mental health concern or not.
And then I think secondly, the,
the other demand that we we're definitely seeing a lot of growth
in is the,
what I would describe as the care that we provide after hours and between
planned visits.
So our urgent cares volumes have increased significantly,
both for, um, in-person visits as well as virtual.
Our virtual volumes are equal to that of our in-person locations.
And so we're responding to the, uh,
opportunities there for expansion in urgent care.
And then secondly, in the pediatrician offices,
we've seen significant increase in the requests for advice and support
by phone and electronic health record. Um,
our pediatricians and triage nurses are providing much more advice and support
than ever before.
So working on workflow redesign to optimize triage,
respond to those requests for advice.
This year we will be launching asynchronous visit through our electronic
health records for some very defined acute conditions so that we can really
expedite the care and provide it in a, in a convenient way.
You certainly covered a lot of ground there, Mary, and that's, uh,
very impressive what Children's of Wisconsin has in front of it.
So what do you think you're most excited about right now?
And to follow up with that, what makes you nervous?
Well,
I think probably what I'm most excited about is our updated strategy within the
organization. Our, um,
vision is that Wisconsin's kids will be the healthiest in the nation,
and we've really taken that to a much more specific call to action to really
look at addressing whole health, which is really what's needed right now, um,
post pandemic.
And it's really redefining the experience for
pediatric healthcare,
not only to address what we're currently doing for physical, mental, social,
and even dental care. We do provide dental care in our clinics,
but really stepping it up in a way that meets families and where they
are right now and what they need.
And so it's a much more intentional focus on not only what
we're providing in terms of care, but how we're providing it.
Um, I'm certainly, um,
I guess excited or pleased to see a greater emphasis and attention
in society as a whole on mental and emotional health.
Um, you know, as difficult as the pandemic was, I,
I guess that's one good thing I see is that the stigma has
decreased around, um,
talking about mental health and, uh,
really looking at what we can do to improve outcome outcomes
around mental, social, and the emotional needs of kids. Um,
as far as what makes me nervous, I don't know that I'm necessarily nervous,
I would say, you know,
there are two challenges that we're really working on addressing.
One is catching up on preventive care gaps and really
trying to close those.
I I do worry about long-term health outcomes and
how much attention has been pulled away from preventive care.
So we see our pediatricians addressing more questions
from parents about vaccines,
really helping them work through any hesitancy to vaccinate.
And then, uh,
we're really working on better identifying those children with preventive care
gaps and taking every opportunity we can to address 'em.
It's just so important right now. And then secondly,
I think the other challenge is really balancing our
improvement plans and keeping them on track while also
responding to some of the post pandemic disrupt disruptors, like,
you know, the last viral surge. Um, I,
I talk about working in the business as well as on the business
and, and,
and really working with our leadership team to make sure they're taking time to
step back and focus on reassessing
things and what can we do better.
And it's difficult to do that when you're also trying to support the
care teams through a, a viral surge like we had last fall. So,
um,
we've learned to be very intentional about the pace and timing of improvement
initiatives and then really trying to build in agility and, um,
be prepared for what may come next.
Uh, Mary, what do you think in pediatrics deserves a brighter spotlight?
I know you mentioned mental healthcare and how it is getting more attention,
same with dental care. Uh, what would you like to see more attention paid?
You know, Chris, I, I don't know. I really think that the mental,
social, emotional components,
if we can figure out how to bring that bundle
together in a, in a really strong way with, with the,
with the physical care, um, I,
I always talk about how,
for me working in pediatrics has been about, um,
the legacy we will leave in the,
the kids today and what their health outcomes are in the future.
And so, um,
for me it's thinking about what am I doing today?
And it's not necessarily my legacy as a healthcare leader, it's more, um,
that legacy showing up in the health outcomes of our future adults
and, and those, that's who we're taking care of right now. So, um,
we've spent a lot of time over the years in the 30 years that I've been in
pediatrics, it's strong emphasis on physical and,
and, and the opportunity right now is broadening that. Um,
so I think it's, I think we're, I think that is the bright spot for us.
And then the other thing I'll say is, you know,
one of the great things about working in pediatrics is kids are so much more
resilient sometimes than we give them credit for and they bounce back.
And, um, you know, that's where I've always, um,
garnered my own, uh,
hope and resiliency is working with those, uh,
families and the children and seeing how they do come through the challenge.
Uh, you spoke about the wonderful legacy of Children's,
of Wisconsin and you've been able to see,
take the long view of it as someone who's been there for 30 years.
So what would you say to other leaders who,
in your position and how to really promote the health of children moving
forward over say the next 30 years?
I think it is about stepping back and taking the long look.
Um,
it is so easy to get caught up in the immediate and the
urgent that, uh, we face every day.
And, um, you know,
part of that is part of your own wellbeing as well as a leader, is to recognize,
um, your thoughts and, um, how they, uh,
are impacting your own results and then supporting yourself to,
to, to think through that and giving yourself the time to do it. So I,
I think it is about taking the long view.
Mary, it was an absolute pleasure speaking with you today.
Thank you so much for your insights,
and we look forward to connecting with you soon. Thank.
You, Chris. It's been a pleasure.