1 00:00:03,705 --> 00:00:06,965 It is so important for leaders at the top of organizations to keep learning, 2 00:00:07,115 --> 00:00:07,875 stay sharp, 3 00:00:07,875 --> 00:00:11,685 grow their networks to help our audience better do this in a more simplified, 4 00:00:11,685 --> 00:00:16,165 personalized, and meaningful way. Becker's Healthcare has launched my BHC, 5 00:00:16,595 --> 00:00:19,925 it's your trusted Becker's healthcare experience and more experie with content, 6 00:00:19,955 --> 00:00:22,125 connections, events, and learning opportunities. 7 00:00:22,875 --> 00:00:27,805 Join the community free of charge@www.my dot becker's hospital 8 00:00:27,805 --> 00:00:29,685 review.com and we'll see you there. 9 00:00:34,065 --> 00:00:36,395 This is Chris Sosa with the Becker's Healthcare Podcast. 10 00:00:36,855 --> 00:00:38,835 I'm thrilled today to be joined by Mary Si, 11 00:00:39,225 --> 00:00:43,115 vice President of Primary Care at Children's Hospital of Wisconsin. Mary, 12 00:00:43,115 --> 00:00:44,195 thank you for joining us today. 13 00:00:45,675 --> 00:00:48,295 Oh, you're very welcome, Chris. Thank you for the opportunity. 14 00:00:49,195 --> 00:00:51,985 Could you please introduce yourself and tell us a bit about your background? 15 00:00:53,635 --> 00:00:55,615 I'd be happy to. So, I'm Mary Si. 16 00:00:55,975 --> 00:01:00,855 I serve as Vice President for the primary care division at 17 00:01:01,055 --> 00:01:05,815 Children's Hospital of Wisconsin in Milwaukee. Um, my background, I, 18 00:01:05,975 --> 00:01:10,885 I have a bachelor's degree in nursing and an MBA and my 19 00:01:10,885 --> 00:01:15,045 career has been in pediatrics for over 30 years. Um, 20 00:01:15,105 --> 00:01:20,045 and also a life leadership coach. I started in my first leadership role, 21 00:01:20,865 --> 00:01:23,605 um, in operations, in ambulatory specialty, 22 00:01:24,745 --> 00:01:27,525 and then really have been very fortunate to, 23 00:01:27,665 --> 00:01:30,205 to be able to kind of move around the organization. 24 00:01:30,275 --> 00:01:33,125 I've worked inpatient care for a period of time, 25 00:01:33,305 --> 00:01:38,205 and then I shifted into leadership roles in strategic management 26 00:01:38,385 --> 00:01:42,335 and business development, and now for the last eight years, 27 00:01:42,645 --> 00:01:46,255 have been backing operations for our primary care division, 28 00:01:46,635 --> 00:01:48,335 and that includes, um, 29 00:01:48,635 --> 00:01:52,535 urgent care services and our children's medical group. 30 00:01:53,875 --> 00:01:58,775 And in round numbers we have about 150 pediatricians 31 00:01:59,155 --> 00:02:03,695 and around 500 employees that provide primary and urgent care 32 00:02:04,055 --> 00:02:08,695 services in over, uh, 20 locations across southeast Wisconsin. 33 00:02:10,245 --> 00:02:12,775 What do you think led to your shift to leadership? 34 00:02:14,105 --> 00:02:17,965 Oh, that's a good question. I think for me it was, um, 35 00:02:18,885 --> 00:02:22,245 recognizing I always had a, uh, 36 00:02:22,385 --> 00:02:26,805 desire to analyze things as they are and see how they could be better. 37 00:02:28,485 --> 00:02:30,705 And so as I shifted from nursing, 38 00:02:30,905 --> 00:02:34,465 I think my probably first foray that was, um, 39 00:02:34,655 --> 00:02:38,945 just looking at quality within healthcare and, um, 40 00:02:39,385 --> 00:02:44,105 starting out as a member of a quality committee and, um, 41 00:02:45,145 --> 00:02:50,105 recognizing the impact that happens when you step out of the 42 00:02:50,385 --> 00:02:55,145 business for a period of time to analyze what you're doing so that you can 43 00:02:55,145 --> 00:02:57,265 improve what you're doing in the business. 44 00:02:57,565 --> 00:03:00,885 And so I think that's how I would describe, um, 45 00:03:00,985 --> 00:03:05,595 how I think about leadership and how I navigated my way there. 46 00:03:07,925 --> 00:03:10,605 Terrific. Mary, what would you say are your top priorities today? 47 00:03:12,745 --> 00:03:14,355 Well, they really fall under, 48 00:03:14,595 --> 00:03:18,995 I would say two broad categories of attention and they're equally important. 49 00:03:20,375 --> 00:03:20,775 Uh, 50 00:03:20,775 --> 00:03:25,715 the first is really making sure our providers and teams have what they need 51 00:03:25,855 --> 00:03:30,435 to do and really be their best. Um, you know, 52 00:03:30,475 --> 00:03:35,165 I think workforce stabilization has been a big priority 53 00:03:35,305 --> 00:03:38,245 in healthcare, uh, over the last couple years. 54 00:03:38,585 --> 00:03:43,285 Our vacancy rates have stabilized and we've done that with some really novel 55 00:03:44,245 --> 00:03:48,205 pipeline programs for all our roles in the care team, uh, 56 00:03:48,205 --> 00:03:52,125 including front desk, our medical assistant and our nursing roles. 57 00:03:52,385 --> 00:03:57,325 And so now we're kind of really shifting to added 58 00:03:57,325 --> 00:04:01,765 attention in, in advancing professional growth and development. 59 00:04:02,225 --> 00:04:06,965 So things like redesigning orientation and onboarding 60 00:04:07,225 --> 00:04:09,005 and our preceptor program, 61 00:04:09,825 --> 00:04:14,765 really understanding our current workforce and 62 00:04:14,895 --> 00:04:19,725 supporting employees to be able to advance along that 63 00:04:19,945 --> 00:04:24,725 novice to expert continuum and reinforce the 64 00:04:24,725 --> 00:04:29,045 sense of purpose in the work and engagement in the organization. 65 00:04:30,405 --> 00:04:35,265 Um, so that's, that's one thing. And definitely wellbeing plays into that. Um, 66 00:04:35,555 --> 00:04:39,905 we've had significant attention in supporting wellbeing. 67 00:04:40,085 --> 00:04:43,265 We really, prior to the pandemic, um, 68 00:04:43,865 --> 00:04:46,905 children's has a very strong foundation of culture, um, 69 00:04:46,925 --> 00:04:49,465 called at our best and at our best together, 70 00:04:50,365 --> 00:04:55,185 and included in that is our value of health for ourselves and for 71 00:04:55,185 --> 00:04:57,585 each other. So, you know, post pan, 72 00:04:57,585 --> 00:05:00,945 fortunately we had that value and it was very strong. 73 00:05:01,185 --> 00:05:06,025 I think it helped us as an organization get through the pandemic and 74 00:05:06,045 --> 00:05:10,825 now post pandemic, we've really augmented that with, uh, 75 00:05:10,925 --> 00:05:14,785 on our team with a training in trauma-informed care. 76 00:05:16,085 --> 00:05:20,705 And the intent of that was not only to gain a greater understanding 77 00:05:21,125 --> 00:05:25,185 of the impact of trauma on families we serve, 78 00:05:25,245 --> 00:05:29,145 but also acknowledging how we support each other and enhance our own resiliency. 79 00:05:30,205 --> 00:05:34,465 So that's been part of it. Definitely. Um, you know, 80 00:05:34,735 --> 00:05:38,625 tied into that, uh, workforce strategy is leadership presence, 81 00:05:38,865 --> 00:05:42,665 rounding with our teams, and then additionally, 82 00:05:43,725 --> 00:05:44,558 um, 83 00:05:44,665 --> 00:05:49,665 recognizing that how important it is for our team 84 00:05:49,665 --> 00:05:54,185 members to have a sense of community and particularly within the roles 85 00:05:54,655 --> 00:05:57,845 that they fulfill in the clinics. 86 00:05:58,065 --> 00:06:02,605 So we've had opportunities for all of our different roles, 87 00:06:02,785 --> 00:06:06,805 the front desk role, our advanced practice nurses, 88 00:06:07,625 --> 00:06:12,245 um, and PAs, our, uh, MAs to come together, 89 00:06:12,355 --> 00:06:14,605 network share feedback, 90 00:06:15,065 --> 00:06:18,685 and generate ideas on where we can improve. And that has really, 91 00:06:19,265 --> 00:06:23,085 for a team that is spread out across 20 locations, 92 00:06:24,145 --> 00:06:29,005 it has broadened that sense of community within those specific roles 93 00:06:29,385 --> 00:06:32,725 and given them, uh, a place to network and learn. 94 00:06:33,745 --> 00:06:36,125 So that's the workforce piece of it. 95 00:06:36,725 --> 00:06:41,645 I think the second is really responding to the evolving needs that our 96 00:06:41,845 --> 00:06:45,135 families are having. So those needs are evolving, 97 00:06:46,435 --> 00:06:51,135 and we're really trying to look at how we do that in a way that's not only 98 00:06:51,735 --> 00:06:52,815 efficient for the care team, 99 00:06:53,075 --> 00:06:58,015 but also provides an efficient experience for families. So, you know, 100 00:06:58,015 --> 00:07:02,815 primary care is where caregivers go for guidance and reassurance 101 00:07:03,075 --> 00:07:07,055 as they kind of navigate the milestones of childhood. 102 00:07:07,595 --> 00:07:12,295 And so our parents really speak of their pediatrician as one of the most 103 00:07:12,295 --> 00:07:15,695 important relationships they've had. And, um, 104 00:07:15,895 --> 00:07:20,175 I always talk about the care that's provided by our pre pediatricians 105 00:07:20,665 --> 00:07:24,975 falls into three areas, preventive care, acute care, 106 00:07:25,395 --> 00:07:28,775 and then chronic conditions such as asthma and ADHD. 107 00:07:29,915 --> 00:07:34,695 And so when we're as committed as we are to providing the very best across all 108 00:07:34,695 --> 00:07:38,455 those areas, we have to look at multitude of things. 109 00:07:38,635 --> 00:07:41,415 So ease of access to care is one thing right now. 110 00:07:41,695 --> 00:07:46,615 I think convenience is such a significant factor in how families 111 00:07:46,615 --> 00:07:48,735 think about accessing care, 112 00:07:49,845 --> 00:07:54,415 enhancing the service and experience in the actual visits. 113 00:07:55,755 --> 00:08:00,575 One of the most significant investments we've made has 114 00:08:00,575 --> 00:08:02,575 been in providing mental health services. 115 00:08:03,435 --> 00:08:08,135 So our pediatricians we're seeing in increase in mental health 116 00:08:08,295 --> 00:08:12,855 concerns prior to the pandemic. And we at that time were, um, 117 00:08:12,855 --> 00:08:15,775 increasing existing services in response. 118 00:08:16,595 --> 00:08:19,735 And now with the exponential needs post pandemic, 119 00:08:20,395 --> 00:08:25,335 we have completely transitioned to an integrated preventive behavioral 120 00:08:25,335 --> 00:08:28,055 health healthcare model in all of our clinics. 121 00:08:29,075 --> 00:08:34,055 And this is with licensed therapists as part of the provider team. Um, 122 00:08:34,155 --> 00:08:38,775 the model is very intentional to not only address the 123 00:08:38,775 --> 00:08:43,535 current high demand for acute mental concerns, 124 00:08:43,995 --> 00:08:47,455 but also providing Prevental health across all age groups. 125 00:08:47,675 --> 00:08:52,575 So our therapists are introduced to families in our preventive well visits, 126 00:08:52,955 --> 00:08:56,925 and it's regardless of whether there's a mental health concern or not. 127 00:08:57,945 --> 00:08:59,805 And then I think secondly, the, 128 00:09:00,025 --> 00:09:04,805 the other demand that we we're definitely seeing a lot of growth 129 00:09:04,905 --> 00:09:06,285 in is the, 130 00:09:06,435 --> 00:09:10,285 what I would describe as the care that we provide after hours and between 131 00:09:10,555 --> 00:09:11,565 planned visits. 132 00:09:12,665 --> 00:09:16,765 So our urgent cares volumes have increased significantly, 133 00:09:17,755 --> 00:09:21,365 both for, um, in-person visits as well as virtual. 134 00:09:22,385 --> 00:09:26,045 Our virtual volumes are equal to that of our in-person locations. 135 00:09:27,225 --> 00:09:30,645 And so we're responding to the, uh, 136 00:09:30,645 --> 00:09:33,805 opportunities there for expansion in urgent care. 137 00:09:34,745 --> 00:09:37,805 And then secondly, in the pediatrician offices, 138 00:09:38,655 --> 00:09:43,125 we've seen significant increase in the requests for advice and support 139 00:09:44,225 --> 00:09:47,685 by phone and electronic health record. Um, 140 00:09:47,785 --> 00:09:52,405 our pediatricians and triage nurses are providing much more advice and support 141 00:09:52,405 --> 00:09:53,325 than ever before. 142 00:09:54,345 --> 00:09:58,845 So working on workflow redesign to optimize triage, 143 00:09:59,115 --> 00:10:01,485 respond to those requests for advice. 144 00:10:02,715 --> 00:10:07,525 This year we will be launching asynchronous visit through our electronic 145 00:10:07,525 --> 00:10:12,285 health records for some very defined acute conditions so that we can really 146 00:10:12,325 --> 00:10:16,245 expedite the care and provide it in a, in a convenient way. 147 00:10:18,385 --> 00:10:21,645 You certainly covered a lot of ground there, Mary, and that's, uh, 148 00:10:21,645 --> 00:10:25,045 very impressive what Children's of Wisconsin has in front of it. 149 00:10:25,305 --> 00:10:27,605 So what do you think you're most excited about right now? 150 00:10:28,305 --> 00:10:30,805 And to follow up with that, what makes you nervous? 151 00:10:33,105 --> 00:10:33,555 Well, 152 00:10:33,555 --> 00:10:38,395 I think probably what I'm most excited about is our updated strategy within the 153 00:10:38,395 --> 00:10:40,955 organization. Our, um, 154 00:10:40,955 --> 00:10:45,035 vision is that Wisconsin's kids will be the healthiest in the nation, 155 00:10:45,975 --> 00:10:50,955 and we've really taken that to a much more specific call to action to really 156 00:10:50,955 --> 00:10:55,595 look at addressing whole health, which is really what's needed right now, um, 157 00:10:55,665 --> 00:10:56,515 post pandemic. 158 00:10:57,495 --> 00:11:01,995 And it's really redefining the experience for 159 00:11:02,025 --> 00:11:03,075 pediatric healthcare, 160 00:11:04,055 --> 00:11:08,515 not only to address what we're currently doing for physical, mental, social, 161 00:11:09,015 --> 00:11:12,355 and even dental care. We do provide dental care in our clinics, 162 00:11:12,855 --> 00:11:17,795 but really stepping it up in a way that meets families and where they 163 00:11:17,795 --> 00:11:19,155 are right now and what they need. 164 00:11:19,455 --> 00:11:23,995 And so it's a much more intentional focus on not only what 165 00:11:24,245 --> 00:11:28,715 we're providing in terms of care, but how we're providing it. 166 00:11:29,575 --> 00:11:31,635 Um, I'm certainly, um, 167 00:11:32,395 --> 00:11:37,235 I guess excited or pleased to see a greater emphasis and attention 168 00:11:38,335 --> 00:11:42,995 in society as a whole on mental and emotional health. 169 00:11:44,055 --> 00:11:48,155 Um, you know, as difficult as the pandemic was, I, 170 00:11:48,355 --> 00:11:52,835 I guess that's one good thing I see is that the stigma has 171 00:11:53,075 --> 00:11:55,945 decreased around, um, 172 00:11:56,855 --> 00:11:59,785 talking about mental health and, uh, 173 00:11:59,805 --> 00:12:04,505 really looking at what we can do to improve outcome outcomes 174 00:12:04,565 --> 00:12:09,425 around mental, social, and the emotional needs of kids. Um, 175 00:12:10,045 --> 00:12:14,065 as far as what makes me nervous, I don't know that I'm necessarily nervous, 176 00:12:14,385 --> 00:12:16,185 I would say, you know, 177 00:12:16,185 --> 00:12:20,585 there are two challenges that we're really working on addressing. 178 00:12:21,005 --> 00:12:25,945 One is catching up on preventive care gaps and really 179 00:12:25,945 --> 00:12:27,025 trying to close those. 180 00:12:27,625 --> 00:12:32,105 I I do worry about long-term health outcomes and 181 00:12:32,765 --> 00:12:36,465 how much attention has been pulled away from preventive care. 182 00:12:37,685 --> 00:12:42,625 So we see our pediatricians addressing more questions 183 00:12:42,735 --> 00:12:44,705 from parents about vaccines, 184 00:12:45,565 --> 00:12:49,945 really helping them work through any hesitancy to vaccinate. 185 00:12:50,885 --> 00:12:51,865 And then, uh, 186 00:12:52,075 --> 00:12:56,465 we're really working on better identifying those children with preventive care 187 00:12:56,615 --> 00:13:00,785 gaps and taking every opportunity we can to address 'em. 188 00:13:01,135 --> 00:13:04,905 It's just so important right now. And then secondly, 189 00:13:05,025 --> 00:13:09,895 I think the other challenge is really balancing our 190 00:13:09,925 --> 00:13:14,295 improvement plans and keeping them on track while also 191 00:13:14,585 --> 00:13:19,055 responding to some of the post pandemic disrupt disruptors, like, 192 00:13:19,355 --> 00:13:22,615 you know, the last viral surge. Um, I, 193 00:13:22,695 --> 00:13:27,335 I talk about working in the business as well as on the business 194 00:13:27,555 --> 00:13:28,235 and, and, 195 00:13:28,235 --> 00:13:32,975 and really working with our leadership team to make sure they're taking time to 196 00:13:32,975 --> 00:13:37,695 step back and focus on reassessing 197 00:13:37,695 --> 00:13:40,335 things and what can we do better. 198 00:13:40,755 --> 00:13:45,655 And it's difficult to do that when you're also trying to support the 199 00:13:45,655 --> 00:13:50,215 care teams through a, a viral surge like we had last fall. So, 200 00:13:50,915 --> 00:13:51,705 um, 201 00:13:51,705 --> 00:13:55,975 we've learned to be very intentional about the pace and timing of improvement 202 00:13:55,975 --> 00:14:00,895 initiatives and then really trying to build in agility and, um, 203 00:14:01,475 --> 00:14:03,415 be prepared for what may come next. 204 00:14:05,495 --> 00:14:10,235 Uh, Mary, what do you think in pediatrics deserves a brighter spotlight? 205 00:14:10,515 --> 00:14:14,715 I know you mentioned mental healthcare and how it is getting more attention, 206 00:14:14,945 --> 00:14:18,875 same with dental care. Uh, what would you like to see more attention paid? 207 00:14:19,965 --> 00:14:24,865 You know, Chris, I, I don't know. I really think that the mental, 208 00:14:24,965 --> 00:14:26,985 social, emotional components, 209 00:14:27,525 --> 00:14:32,105 if we can figure out how to bring that bundle 210 00:14:32,465 --> 00:14:36,825 together in a, in a really strong way with, with the, 211 00:14:36,855 --> 00:14:40,745 with the physical care, um, I, 212 00:14:40,945 --> 00:14:42,425 I always talk about how, 213 00:14:44,305 --> 00:14:48,505 for me working in pediatrics has been about, um, 214 00:14:48,765 --> 00:14:52,885 the legacy we will leave in the, 215 00:14:52,985 --> 00:14:56,405 the kids today and what their health outcomes are in the future. 216 00:14:57,615 --> 00:14:58,835 And so, um, 217 00:14:59,535 --> 00:15:03,115 for me it's thinking about what am I doing today? 218 00:15:03,815 --> 00:15:08,715 And it's not necessarily my legacy as a healthcare leader, it's more, um, 219 00:15:09,825 --> 00:15:14,795 that legacy showing up in the health outcomes of our future adults 220 00:15:15,055 --> 00:15:19,635 and, and those, that's who we're taking care of right now. So, um, 221 00:15:21,765 --> 00:15:24,955 we've spent a lot of time over the years in the 30 years that I've been in 222 00:15:24,955 --> 00:15:29,035 pediatrics, it's strong emphasis on physical and, 223 00:15:30,195 --> 00:15:34,095 and, and the opportunity right now is broadening that. Um, 224 00:15:35,515 --> 00:15:39,855 so I think it's, I think we're, I think that is the bright spot for us. 225 00:15:40,635 --> 00:15:42,775 And then the other thing I'll say is, you know, 226 00:15:42,775 --> 00:15:47,415 one of the great things about working in pediatrics is kids are so much more 227 00:15:47,775 --> 00:15:52,135 resilient sometimes than we give them credit for and they bounce back. 228 00:15:52,675 --> 00:15:56,415 And, um, you know, that's where I've always, um, 229 00:15:56,975 --> 00:15:59,015 garnered my own, uh, 230 00:15:59,085 --> 00:16:03,015 hope and resiliency is working with those, uh, 231 00:16:03,255 --> 00:16:08,055 families and the children and seeing how they do come through the challenge. 232 00:16:09,215 --> 00:16:11,835 Uh, you spoke about the wonderful legacy of Children's, 233 00:16:11,835 --> 00:16:13,915 of Wisconsin and you've been able to see, 234 00:16:14,945 --> 00:16:17,875 take the long view of it as someone who's been there for 30 years. 235 00:16:18,375 --> 00:16:22,115 So what would you say to other leaders who, 236 00:16:22,115 --> 00:16:27,115 in your position and how to really promote the health of children moving 237 00:16:27,115 --> 00:16:28,835 forward over say the next 30 years? 238 00:16:30,725 --> 00:16:34,845 I think it is about stepping back and taking the long look. 239 00:16:35,795 --> 00:16:36,395 Um, 240 00:16:36,395 --> 00:16:41,395 it is so easy to get caught up in the immediate and the 241 00:16:41,395 --> 00:16:45,555 urgent that, uh, we face every day. 242 00:16:46,655 --> 00:16:48,155 And, um, you know, 243 00:16:48,155 --> 00:16:53,155 part of that is part of your own wellbeing as well as a leader, is to recognize, 244 00:16:53,775 --> 00:16:58,635 um, your thoughts and, um, how they, uh, 245 00:16:59,175 --> 00:17:04,075 are impacting your own results and then supporting yourself to, 246 00:17:04,495 --> 00:17:09,165 to, to think through that and giving yourself the time to do it. So I, 247 00:17:09,445 --> 00:17:11,885 I think it is about taking the long view. 248 00:17:12,595 --> 00:17:15,245 Mary, it was an absolute pleasure speaking with you today. 249 00:17:15,245 --> 00:17:16,805 Thank you so much for your insights, 250 00:17:16,825 --> 00:17:19,365 and we look forward to connecting with you soon. Thank. 251 00:17:20,205 --> 00:17:22,005 You, Chris. It's been a pleasure.