1 00:00:00,080 --> 00:00:02,319 Welcome to Becker's Health Care podcast. I'm Chris 2 00:00:02,319 --> 00:00:04,000 Sosa, your host, and I'm thrilled to be 3 00:00:04,000 --> 00:00:06,080 joined today by doctor James Moore. He is 4 00:00:06,080 --> 00:00:08,400 president of the Connecticut Children's Specialty Group and 5 00:00:08,400 --> 00:00:10,880 the system chief medical officer and chief clinical 6 00:00:10,880 --> 00:00:13,460 network development officer for Connecticut Children's. 7 00:00:13,919 --> 00:00:15,924 Jim, thank you for joining us today. Hi, 8 00:00:15,924 --> 00:00:17,704 Chris. I appreciate the opportunity. 9 00:00:18,724 --> 00:00:19,864 As as you mentioned, 10 00:00:20,244 --> 00:00:21,785 I'm doctor Jim Moore. 11 00:00:22,804 --> 00:00:25,524 I also, in addition to the system chief 12 00:00:25,524 --> 00:00:26,504 medical officer, 13 00:00:27,809 --> 00:00:30,850 and president of our Connecticut Children's Specialty Group. 14 00:00:30,850 --> 00:00:32,149 I'm also a practicing 15 00:00:32,609 --> 00:00:34,950 newborn intensive care doctor or neonatologist 16 00:00:35,329 --> 00:00:36,710 here at our level four, 17 00:00:37,489 --> 00:00:39,989 NICU here in Hartford at Connecticut Children's. 18 00:00:40,554 --> 00:00:42,234 Perfect, Tim. Thanks you for giving us a 19 00:00:42,234 --> 00:00:44,414 little bit of overview of what your career 20 00:00:44,475 --> 00:00:44,975 entails. 21 00:00:45,515 --> 00:00:47,115 Today, we've got you on the podcast to 22 00:00:47,115 --> 00:00:49,115 discuss any number of things going on at 23 00:00:49,115 --> 00:00:51,435 Connecticut Children's. Clearly, things have been busy over 24 00:00:51,435 --> 00:00:52,469 there, which is great. 25 00:00:53,030 --> 00:00:54,789 So let's start with this. Let's look back 26 00:00:54,789 --> 00:00:56,010 at 2025, 27 00:00:56,070 --> 00:00:57,750 and that is simply what would you say 28 00:00:57,750 --> 00:00:59,929 is the most important initiative or initiatives 29 00:01:00,469 --> 00:01:02,149 that you led in the last year? Just 30 00:01:02,149 --> 00:01:03,990 take us through how they evolved and the 31 00:01:03,990 --> 00:01:04,969 results of them. 32 00:01:05,754 --> 00:01:07,594 Sure. If you don't mind, I might like 33 00:01:07,594 --> 00:01:10,075 to even back up just because I'm sure 34 00:01:10,075 --> 00:01:12,634 some of the listeners might not know what 35 00:01:12,634 --> 00:01:14,954 Connecticut Children's is, and if I could just 36 00:01:14,954 --> 00:01:17,295 take a moment to just maybe 37 00:01:17,594 --> 00:01:18,655 give a highlighted, 38 00:01:19,274 --> 00:01:20,129 view of that. 39 00:01:20,689 --> 00:01:21,250 We are, 40 00:01:22,049 --> 00:01:22,709 the only 41 00:01:23,170 --> 00:01:23,670 independent, 42 00:01:24,769 --> 00:01:25,269 nonprofit 43 00:01:26,049 --> 00:01:29,329 health system in Connecticut and only one of 44 00:01:29,329 --> 00:01:30,629 two in New England 45 00:01:30,930 --> 00:01:32,549 that's actually a 100% 46 00:01:32,609 --> 00:01:33,829 dedicated to 47 00:01:34,289 --> 00:01:37,155 pediatric care. We are a freestanding 48 00:01:38,094 --> 00:01:40,975 children's hospital located here in Hartford, but we're 49 00:01:40,975 --> 00:01:41,475 also 50 00:01:42,015 --> 00:01:43,234 a health system, 51 00:01:43,855 --> 00:01:44,674 that actually 52 00:01:45,135 --> 00:01:45,635 has, 53 00:01:46,814 --> 00:01:49,935 facilities and services in three different states in 54 00:01:49,935 --> 00:01:50,435 Connecticut, 55 00:01:51,180 --> 00:01:51,680 Massachusetts, 56 00:01:52,459 --> 00:01:53,359 and New York. 57 00:01:54,140 --> 00:01:54,540 As, 58 00:01:55,020 --> 00:01:55,520 Chris, 59 00:01:56,060 --> 00:01:58,459 mentioned to you earlier, we actually just opened 60 00:01:58,459 --> 00:01:59,760 up a brand new 61 00:02:00,219 --> 00:02:01,819 190,000 62 00:02:01,819 --> 00:02:04,125 square foot tower this past December. 63 00:02:05,224 --> 00:02:07,545 We now have about 215 64 00:02:07,545 --> 00:02:09,245 beds in our primary facility. 65 00:02:10,664 --> 00:02:13,064 And in addition to that, we partner with 66 00:02:13,064 --> 00:02:14,925 three adult hospital systems, 67 00:02:15,864 --> 00:02:16,364 across 68 00:02:16,664 --> 00:02:19,405 the two states, in Connecticut and New York, 69 00:02:20,080 --> 00:02:23,040 and provide care to 15 different hospitals other 70 00:02:23,040 --> 00:02:23,699 than that. 71 00:02:24,240 --> 00:02:26,800 Our 30 specialty and primary care centers are 72 00:02:26,800 --> 00:02:27,300 located 73 00:02:28,080 --> 00:02:29,699 in Connecticut, Massachusetts, 74 00:02:30,159 --> 00:02:31,060 and New York, 75 00:02:31,534 --> 00:02:33,854 and we have about 570 76 00:02:33,854 --> 00:02:37,314 specialists. We're an academic training center for Yukon. 77 00:02:38,175 --> 00:02:40,895 We have students, residents, and fellows. We're also 78 00:02:40,895 --> 00:02:42,034 involved in research 79 00:02:42,415 --> 00:02:44,514 and innovation initiatives. So, 80 00:02:45,139 --> 00:02:46,819 a lot of times, I think people just 81 00:02:46,819 --> 00:02:47,699 assume we're, 82 00:02:48,020 --> 00:02:51,300 freestanding children's hospital in Downtown Hartford, but we're 83 00:02:51,300 --> 00:02:52,759 actually much more regionalized. 84 00:02:54,020 --> 00:02:56,099 Wonderful. Jim, thank you for clarifying all of 85 00:02:56,099 --> 00:02:57,465 that. I'm glad you got a chance to 86 00:02:57,465 --> 00:02:58,205 let us know 87 00:02:58,504 --> 00:03:00,444 more about what Connecticut's 88 00:03:00,905 --> 00:03:02,905 Connecticut Children's is all about and all the 89 00:03:02,905 --> 00:03:03,405 affiliations 90 00:03:03,705 --> 00:03:05,645 and all the work that you and your 91 00:03:05,784 --> 00:03:08,444 compatriots do over there. So, yes, 92 00:03:09,379 --> 00:03:11,540 thank you for taking us through that. Let's 93 00:03:11,540 --> 00:03:13,300 look at at 2025. 94 00:03:13,300 --> 00:03:15,719 So you have a lot going on. 95 00:03:16,180 --> 00:03:17,800 What would you say is the most important 96 00:03:17,860 --> 00:03:19,080 initiative that you led? 97 00:03:19,460 --> 00:03:21,219 Just take us through everything about it, you 98 00:03:21,219 --> 00:03:22,680 know, whether it's how it started, 99 00:03:23,060 --> 00:03:25,335 what the results were, and anything else you 100 00:03:25,335 --> 00:03:26,634 find important in this moment. 101 00:03:27,254 --> 00:03:29,414 I appreciate that. And I think, you know, 102 00:03:29,414 --> 00:03:30,854 as we look at, 103 00:03:31,414 --> 00:03:34,235 health care in general, the economics are 104 00:03:34,534 --> 00:03:37,175 more challenging than ever and our margins are 105 00:03:37,175 --> 00:03:39,754 thinner. So it really puts pressure on us 106 00:03:40,219 --> 00:03:40,800 to perform 107 00:03:41,259 --> 00:03:42,719 at the highest level. 108 00:03:43,259 --> 00:03:45,500 I'd like to actually maybe touch on two 109 00:03:45,500 --> 00:03:46,560 different initiatives. 110 00:03:47,900 --> 00:03:50,780 I'll I'll try to keep them not, 111 00:03:51,259 --> 00:03:53,180 not going on for too long but Hey. 112 00:03:53,180 --> 00:03:54,780 Don't worry about it. One of the the 113 00:03:54,780 --> 00:03:57,324 first challenges we we were facing 114 00:03:58,185 --> 00:03:58,685 was, 115 00:03:59,145 --> 00:03:59,944 capacity and 116 00:04:00,665 --> 00:04:04,025 you know, we definitely had an unmet need 117 00:04:04,025 --> 00:04:04,824 in the market. 118 00:04:05,305 --> 00:04:07,705 We had more patients that needed to come 119 00:04:07,705 --> 00:04:08,205 in. 120 00:04:09,189 --> 00:04:11,530 But I think like a lot of organizations, 121 00:04:11,830 --> 00:04:13,830 we didn't have a ton of capital to 122 00:04:13,830 --> 00:04:15,770 just add bricks and mortar. 123 00:04:16,709 --> 00:04:18,230 So then we had to turn around and 124 00:04:18,230 --> 00:04:20,490 say, alright. How do we accomplish this? And 125 00:04:20,709 --> 00:04:22,569 a lot of this kinda fell on efficiency. 126 00:04:22,709 --> 00:04:23,449 So we've 127 00:04:23,774 --> 00:04:26,334 really needed to be able to track our 128 00:04:26,334 --> 00:04:28,915 space utilization especially around managing 129 00:04:29,855 --> 00:04:30,355 capacity, 130 00:04:31,375 --> 00:04:33,795 in our busiest locations especially. 131 00:04:34,415 --> 00:04:35,475 You know, we 132 00:04:36,095 --> 00:04:39,769 really kinda tackle that in multiple different ways. 133 00:04:39,769 --> 00:04:42,729 We needed to be precise and rigorous in 134 00:04:42,729 --> 00:04:45,449 the management of that utilization. I think the 135 00:04:45,449 --> 00:04:46,189 old school 136 00:04:46,970 --> 00:04:49,789 approach is is that, well, these rooms are 137 00:04:50,175 --> 00:04:52,035 ENT rooms, and these rooms 138 00:04:52,654 --> 00:04:54,975 are general care rooms. We had to take 139 00:04:54,975 --> 00:04:57,794 the approach that they're all kind of touchdown 140 00:04:57,935 --> 00:05:01,875 rooms and multiple different areas can utilize them. 141 00:05:02,329 --> 00:05:05,050 To accomplish that, we actually created dashboards to 142 00:05:05,050 --> 00:05:06,189 look at room utilizations 143 00:05:07,129 --> 00:05:09,449 by each of the divisions that occupied those 144 00:05:09,449 --> 00:05:09,949 clinics 145 00:05:10,730 --> 00:05:13,790 and then rearrange space and utilization to proactively 146 00:05:14,170 --> 00:05:14,910 look at 147 00:05:15,555 --> 00:05:17,955 issues we knew were coming up. I think 148 00:05:17,955 --> 00:05:19,894 a lot of times we all know clinicians 149 00:05:20,754 --> 00:05:22,834 have to spend time in the hospital and 150 00:05:22,834 --> 00:05:24,834 when they're in the hospital they're not in 151 00:05:24,834 --> 00:05:25,334 clinic. 152 00:05:25,875 --> 00:05:26,375 And 153 00:05:26,834 --> 00:05:28,629 as much as I think many of us 154 00:05:28,629 --> 00:05:30,790 don't feel we get enough vacation, we do 155 00:05:30,790 --> 00:05:33,110 take vacation and they're not in the clinic 156 00:05:33,110 --> 00:05:33,850 at that time. 157 00:05:34,230 --> 00:05:36,089 We wanted to be able to proactively 158 00:05:36,389 --> 00:05:38,629 use that space. And a lot of those 159 00:05:38,629 --> 00:05:40,089 instances were known 160 00:05:40,564 --> 00:05:43,125 far enough ahead that we could actually repurpose 161 00:05:43,125 --> 00:05:43,784 the space 162 00:05:44,245 --> 00:05:47,144 and get more patients in in other areas. 163 00:05:48,164 --> 00:05:51,625 That actually was highly successful. We actually increased 164 00:05:51,685 --> 00:05:52,185 volume 165 00:05:52,769 --> 00:05:54,370 by about 14% 166 00:05:54,370 --> 00:05:56,069 in five of our key specialties. 167 00:05:56,610 --> 00:06:00,389 We've also been developing plans for extended hours, 168 00:06:01,569 --> 00:06:04,209 but that's been challenging in its own right 169 00:06:04,209 --> 00:06:04,709 because 170 00:06:05,365 --> 00:06:08,404 getting enough staff even for current operations, let 171 00:06:08,404 --> 00:06:09,544 alone expanding 172 00:06:09,925 --> 00:06:10,425 hours, 173 00:06:11,284 --> 00:06:12,824 has been a bit of a challenge. 174 00:06:13,764 --> 00:06:15,925 The second one, which I won't go into 175 00:06:15,925 --> 00:06:17,544 great detail, which is 176 00:06:18,004 --> 00:06:20,759 essentially the same approach, but, you know, now 177 00:06:20,899 --> 00:06:23,479 turning our sites onto the OR and especially 178 00:06:23,539 --> 00:06:24,039 ambulatory 179 00:06:24,419 --> 00:06:25,240 surgery center 180 00:06:25,779 --> 00:06:26,279 was 181 00:06:26,659 --> 00:06:29,060 ways to get OR case volumes that were 182 00:06:29,060 --> 00:06:31,779 actually backing up in several specialties because they 183 00:06:31,779 --> 00:06:32,919 needed more time 184 00:06:33,485 --> 00:06:35,805 to look at a efficiency and maybe being 185 00:06:35,805 --> 00:06:36,784 able to leverage 186 00:06:37,485 --> 00:06:39,964 the staff in a way that could extend 187 00:06:39,964 --> 00:06:41,345 the sessions without 188 00:06:41,805 --> 00:06:43,985 needing a lot of extra FTEs, 189 00:06:45,245 --> 00:06:47,910 to really address some of those backlogs. In 190 00:06:47,910 --> 00:06:51,269 our instance, that was in urology and NT, 191 00:06:51,269 --> 00:06:51,769 and, 192 00:06:52,229 --> 00:06:55,289 we also saw similar gains, especially in urology, 193 00:06:56,069 --> 00:06:58,169 that we saw on the outpatient side. 194 00:06:59,435 --> 00:07:01,995 Tim, thank you for taking us through everything 195 00:07:01,995 --> 00:07:02,495 that's 196 00:07:02,954 --> 00:07:05,675 Connected Children's is working on. Clearly, it's all 197 00:07:05,675 --> 00:07:08,235 worthwhile, and I'm glad to hear that you've 198 00:07:08,235 --> 00:07:10,974 been able to improve your your use volume, 199 00:07:11,834 --> 00:07:12,735 get more cases 200 00:07:13,514 --> 00:07:14,014 addressed. 201 00:07:14,810 --> 00:07:17,150 Let's look ahead now at 2026. 202 00:07:17,449 --> 00:07:17,949 So 203 00:07:18,970 --> 00:07:20,970 we're a little bit into 2026, but only 204 00:07:20,970 --> 00:07:22,350 a little bit. So 205 00:07:22,970 --> 00:07:25,610 in addition to everything that Connected Children's has 206 00:07:25,610 --> 00:07:27,870 accomplished, you mentioned, the new tower, 207 00:07:28,604 --> 00:07:30,925 Huge things going on there. So when you 208 00:07:30,925 --> 00:07:32,845 look at the next year and maybe a 209 00:07:32,845 --> 00:07:35,564 little bit farther than that, what'd you say 210 00:07:35,564 --> 00:07:37,884 are your biggest priorities and any headwinds you've 211 00:07:37,884 --> 00:07:40,544 got going on? And and on the same 212 00:07:40,845 --> 00:07:43,345 plane, any tailwinds that you're looking at? 213 00:07:43,750 --> 00:07:45,430 Well, I mean, I think that's a a 214 00:07:45,430 --> 00:07:47,910 great question. I think we're all really kinda 215 00:07:47,910 --> 00:07:49,769 focusing on that right now. 216 00:07:50,310 --> 00:07:52,389 We also have a new CEO and a 217 00:07:52,389 --> 00:07:55,610 new chair of pediatrics, and we're we're also 218 00:07:55,669 --> 00:07:58,470 in the midst of of, I think, really 219 00:07:58,470 --> 00:07:59,504 trying to address 220 00:08:00,064 --> 00:08:01,685 a lot of things that are changing 221 00:08:01,985 --> 00:08:02,485 rapidly. 222 00:08:02,865 --> 00:08:05,605 And I think many of us can really, 223 00:08:07,024 --> 00:08:08,564 understand the pain point 224 00:08:09,105 --> 00:08:11,524 of, you know, the issues around, 225 00:08:12,305 --> 00:08:13,444 Medicaid rate 226 00:08:14,079 --> 00:08:17,279 reforms and policy changes that have been going 227 00:08:17,279 --> 00:08:17,779 into 228 00:08:18,160 --> 00:08:18,660 effect. 229 00:08:19,680 --> 00:08:22,079 You know, we we need to pay attention 230 00:08:22,079 --> 00:08:22,979 to that because 231 00:08:23,439 --> 00:08:27,120 that actually is a large driver for for 232 00:08:27,120 --> 00:08:30,664 pediatric hospitals. We have a very high proportion 233 00:08:30,724 --> 00:08:31,224 of 234 00:08:31,604 --> 00:08:32,584 Medicaid reimbursement 235 00:08:32,884 --> 00:08:36,065 and that ends up leaving our margins very 236 00:08:36,325 --> 00:08:36,825 thin, 237 00:08:37,524 --> 00:08:39,684 with the kind of proposed federal and state 238 00:08:39,684 --> 00:08:40,184 changes. 239 00:08:40,804 --> 00:08:42,825 This is gonna make that even more 240 00:08:43,209 --> 00:08:44,029 challenging. So, you know, 241 00:08:44,570 --> 00:08:45,789 to me, I think we've 242 00:08:46,250 --> 00:08:49,129 got issues in the immediate sense, maybe in 243 00:08:49,129 --> 00:08:52,350 the next year, but probably looking long term 244 00:08:52,970 --> 00:08:53,629 as well. 245 00:08:54,169 --> 00:08:57,264 And so, I mean, we obviously need to 246 00:08:57,264 --> 00:08:59,585 work on our efficiencies. We talked a little 247 00:08:59,585 --> 00:09:00,804 bit about that already, 248 00:09:01,585 --> 00:09:02,565 trying to reduce 249 00:09:03,024 --> 00:09:05,524 cost by maybe putting some of the services 250 00:09:05,904 --> 00:09:08,165 as outpatient rather than inpatient. 251 00:09:09,200 --> 00:09:11,759 We also need to get reimbursed appropriately for 252 00:09:11,759 --> 00:09:13,919 the work that we're doing. This means paying 253 00:09:13,919 --> 00:09:17,620 attention to coding and billing, reducing denied claims, 254 00:09:18,320 --> 00:09:20,580 especially for things that are in our control, 255 00:09:21,839 --> 00:09:23,299 and appropriately capturing 256 00:09:23,759 --> 00:09:24,259 revenue. 257 00:09:24,715 --> 00:09:26,095 But I think, realistically, 258 00:09:27,355 --> 00:09:29,695 if we only take the approach to that, 259 00:09:30,154 --> 00:09:32,235 we're only going to maybe get a a 260 00:09:32,235 --> 00:09:35,355 short term benefit. You know, that traditional approach 261 00:09:35,355 --> 00:09:36,174 of of, 262 00:09:36,649 --> 00:09:39,230 you know, getting more bed days, more hospital 263 00:09:39,370 --> 00:09:39,870 volume, 264 00:09:40,410 --> 00:09:43,549 especially in today's climate of, you know, accelerating 265 00:09:43,690 --> 00:09:45,629 costs, decreasing reimbursements 266 00:09:46,649 --> 00:09:48,750 is not gonna be financially sustained. 267 00:09:49,485 --> 00:09:51,985 We actually have to broaden our revenue streams. 268 00:09:52,524 --> 00:09:54,625 You know, I think if we 269 00:09:55,085 --> 00:09:56,384 look to 270 00:09:56,764 --> 00:09:59,184 what our services provided traditionally, 271 00:10:00,125 --> 00:10:03,190 sick care alone actually touched maybe ten percent 272 00:10:03,190 --> 00:10:05,750 of the total pediatric population. We need to 273 00:10:05,750 --> 00:10:07,049 be thinking much more 274 00:10:07,590 --> 00:10:11,190 broadly. And whether that is, you know, through 275 00:10:11,190 --> 00:10:14,809 mechanisms of partnering with primary and preventative care, 276 00:10:15,464 --> 00:10:18,184 partnering with other health systems to put care 277 00:10:18,184 --> 00:10:19,245 closer to home, 278 00:10:19,865 --> 00:10:21,784 maybe home care, getting kids out of the 279 00:10:21,784 --> 00:10:23,804 hospital and and into 280 00:10:24,264 --> 00:10:26,924 a lower cost type of situation. 281 00:10:27,929 --> 00:10:28,429 These 282 00:10:28,889 --> 00:10:30,970 are ways that where you've got to start 283 00:10:30,970 --> 00:10:31,950 thinking about 284 00:10:32,409 --> 00:10:34,269 both improving more lives, 285 00:10:35,289 --> 00:10:37,370 but also doing it in a way that 286 00:10:37,370 --> 00:10:40,409 is going to be sustainable and potentially new 287 00:10:40,409 --> 00:10:41,549 revenue streams. 288 00:10:42,730 --> 00:10:45,245 You know I think the that'll have the 289 00:10:45,245 --> 00:10:47,024 greatest long term impact. 290 00:10:48,284 --> 00:10:49,964 You know, I think one of the ways 291 00:10:49,964 --> 00:10:52,125 that can be done, and that varies kind 292 00:10:52,125 --> 00:10:54,365 of state to state is, you know, value 293 00:10:54,365 --> 00:10:57,000 based care. You know, that in and of 294 00:10:57,000 --> 00:10:57,500 itself 295 00:10:57,800 --> 00:10:58,300 actually 296 00:10:58,759 --> 00:11:01,879 really helps to align reimbursement with what you're 297 00:11:01,879 --> 00:11:03,660 really trying to do long term, 298 00:11:04,200 --> 00:11:05,500 but it also rewards 299 00:11:05,879 --> 00:11:08,840 outcomes and promotes quality. So I think we've 300 00:11:08,840 --> 00:11:11,695 gotta look at new ways to actually provide 301 00:11:11,695 --> 00:11:12,434 the services, 302 00:11:13,054 --> 00:11:14,914 that improve children's health. 303 00:11:15,375 --> 00:11:16,514 We need to actually, 304 00:11:17,695 --> 00:11:19,794 improve quality and outcomes. 305 00:11:20,254 --> 00:11:22,274 We need to touch more lives. 306 00:11:22,879 --> 00:11:24,959 But to be able to sustain ourselves, there 307 00:11:24,959 --> 00:11:26,179 may need to be new 308 00:11:26,559 --> 00:11:29,120 ways to get paid for whether we're doing 309 00:11:29,120 --> 00:11:30,740 school based care or others. 310 00:11:31,440 --> 00:11:34,720 And probably looking at ways for innovation and 311 00:11:34,720 --> 00:11:37,539 development of new technologies because I think the 312 00:11:37,934 --> 00:11:40,575 bed reimbursement in the hospital model is not 313 00:11:40,575 --> 00:11:42,674 going to be the way of the future. 314 00:11:43,535 --> 00:11:45,394 I think a lot of your colleagues in 315 00:11:45,615 --> 00:11:47,615 health care leadership would absolutely agree with you, 316 00:11:47,615 --> 00:11:48,975 Jim. And I'll give you the I do 317 00:11:48,975 --> 00:11:50,759 wanna give you a chance to expand on, 318 00:11:51,240 --> 00:11:53,559 some of those growth opportunities that Connected Children's 319 00:11:53,559 --> 00:11:54,620 has in a minute. 320 00:11:55,559 --> 00:11:58,120 In for the meantime, though, I do wanna 321 00:11:58,120 --> 00:11:59,399 ask you, what do you think is the 322 00:11:59,399 --> 00:12:01,559 hardest thing you're going to have to do 323 00:12:01,559 --> 00:12:03,835 in this coming year? Doesn't mean you're not 324 00:12:03,835 --> 00:12:05,835 looking forward to doing it. Just means you 325 00:12:05,835 --> 00:12:07,915 might need a little bit different level of 326 00:12:07,915 --> 00:12:11,115 focus or community focus to get that goal, 327 00:12:11,115 --> 00:12:12,415 whatever that is, accomplished. 328 00:12:13,514 --> 00:12:15,509 Chris, I think that is is going to 329 00:12:15,509 --> 00:12:18,090 be critical, and I think the way I'll 330 00:12:18,149 --> 00:12:19,690 answer that may be slightly, 331 00:12:21,029 --> 00:12:24,230 different than many people might assume. I I 332 00:12:24,230 --> 00:12:24,730 think 333 00:12:25,110 --> 00:12:27,210 the problem we're all facing 334 00:12:27,830 --> 00:12:28,649 is really 335 00:12:29,269 --> 00:12:30,164 that if 336 00:12:30,485 --> 00:12:32,884 you are looking at the landscape right now, 337 00:12:32,884 --> 00:12:36,184 you've got workforce shortages, you got labor costs 338 00:12:36,485 --> 00:12:38,424 that are all contributing to this. 339 00:12:39,044 --> 00:12:42,184 We're all experiencing this whether it's pediatric specialists, 340 00:12:42,725 --> 00:12:43,225 nurses, 341 00:12:44,450 --> 00:12:45,750 allied health professionals. 342 00:12:46,690 --> 00:12:48,309 This is all really 343 00:12:48,850 --> 00:12:52,210 producing both challenges getting folks in to provide 344 00:12:52,210 --> 00:12:55,190 the services, and it unfortunately is impacting 345 00:12:55,730 --> 00:12:56,950 higher labor costs. 346 00:12:58,475 --> 00:13:00,714 You know, if you try to just say, 347 00:13:00,714 --> 00:13:02,554 well, we'll go out and get new ones 348 00:13:02,554 --> 00:13:04,254 or or not address, 349 00:13:05,034 --> 00:13:05,534 turnover, 350 00:13:06,394 --> 00:13:10,495 recruiting and retaining specialized care is really actually 351 00:13:10,794 --> 00:13:11,695 quite expensive. 352 00:13:12,949 --> 00:13:16,230 And so we're focusing on kinda the the 353 00:13:16,230 --> 00:13:19,190 other side, which is to once you've got 354 00:13:19,190 --> 00:13:20,649 folks in the door, 355 00:13:21,029 --> 00:13:23,669 you wanna make sure they wanna stay. And 356 00:13:23,669 --> 00:13:25,610 I think that's really important. 357 00:13:26,389 --> 00:13:26,889 We 358 00:13:27,345 --> 00:13:30,384 are working, I would say, most diligently right 359 00:13:30,384 --> 00:13:30,884 now 360 00:13:31,264 --> 00:13:32,625 on our culture work. 361 00:13:33,264 --> 00:13:36,065 We call our our work on culture our 362 00:13:36,065 --> 00:13:40,065 one team and providing better health through a 363 00:13:40,065 --> 00:13:41,204 one team approach. 364 00:13:42,009 --> 00:13:44,490 You know, we've had a very strong mission 365 00:13:44,490 --> 00:13:45,309 and I think 366 00:13:45,690 --> 00:13:48,089 anytime you talk about taking care of sick 367 00:13:48,089 --> 00:13:48,589 kids 368 00:13:49,049 --> 00:13:51,309 and, you know, being able to 369 00:13:51,690 --> 00:13:53,789 be involved with kids and families, 370 00:13:54,595 --> 00:13:58,115 it's kinda easier for kid people to get 371 00:13:58,115 --> 00:13:58,615 behind 372 00:13:58,995 --> 00:13:59,975 that. And, 373 00:14:00,274 --> 00:14:02,835 you know, I I think it is gives 374 00:14:02,835 --> 00:14:04,294 us a bit of a head start. 375 00:14:05,235 --> 00:14:07,735 But what we really wanna strive for 376 00:14:08,699 --> 00:14:11,439 is for our our team members to feel 377 00:14:11,740 --> 00:14:14,000 like they actually both belong here 378 00:14:14,779 --> 00:14:16,720 and that they can succeed here. 379 00:14:17,500 --> 00:14:20,299 And that hopefully, they feel they're supportive of 380 00:14:20,299 --> 00:14:23,100 each other. You know, there was a great 381 00:14:23,100 --> 00:14:25,144 description of kinda that mentality 382 00:14:25,445 --> 00:14:28,884 that came from one of our floor team 383 00:14:28,884 --> 00:14:31,125 members. And it was like, you know, the 384 00:14:31,125 --> 00:14:33,065 way they described that was 385 00:14:33,445 --> 00:14:36,404 we want folks to answer the call bell. 386 00:14:36,404 --> 00:14:38,245 You know? When you you got that nurse 387 00:14:38,245 --> 00:14:39,330 call button on 388 00:14:40,129 --> 00:14:42,710 and and, you know, often I've been 389 00:14:43,090 --> 00:14:44,769 even with some of my own family in 390 00:14:44,769 --> 00:14:46,850 the adult hospital and the bell just rings 391 00:14:46,850 --> 00:14:47,509 and rings. 392 00:14:48,049 --> 00:14:50,290 And a lot of times, it's because people 393 00:14:50,290 --> 00:14:52,450 are short staffed or they're taking care of 394 00:14:52,450 --> 00:14:53,190 other families. 395 00:14:53,730 --> 00:14:56,745 What we wanna encourage is is that, you 396 00:14:56,745 --> 00:14:59,304 know, everybody feels empowered to be able to 397 00:14:59,304 --> 00:15:01,464 answer that call bell and take care of 398 00:15:01,464 --> 00:15:03,725 that child and take care of that family. 399 00:15:04,825 --> 00:15:05,325 And 400 00:15:05,784 --> 00:15:06,605 if you can 401 00:15:07,144 --> 00:15:08,764 get that kind of feeling, 402 00:15:09,384 --> 00:15:09,884 if 403 00:15:10,480 --> 00:15:13,220 your team members can feel like they're heard, 404 00:15:13,840 --> 00:15:15,700 more importantly that they're valued, 405 00:15:16,399 --> 00:15:18,720 and that what they're coming to is not 406 00:15:18,720 --> 00:15:19,620 just a job. 407 00:15:20,399 --> 00:15:23,105 They're gonna be much more wanting to stay 408 00:15:23,105 --> 00:15:25,345 in the organization. They feel they can grow 409 00:15:25,345 --> 00:15:26,084 in the organization, 410 00:15:27,105 --> 00:15:28,004 and they 411 00:15:28,304 --> 00:15:31,264 hopefully will be easier to retain. And it's 412 00:15:31,264 --> 00:15:35,024 a lot easier to to manage staffing when 413 00:15:35,024 --> 00:15:37,985 you've retained employees than to constantly be looking 414 00:15:37,985 --> 00:15:38,759 for new ones. 415 00:15:39,559 --> 00:15:41,720 I think we've got that strong culture, but, 416 00:15:41,720 --> 00:15:43,879 you know, I I think we can always 417 00:15:43,879 --> 00:15:44,620 do more. 418 00:15:45,639 --> 00:15:47,399 And then the other thing that we've gotta 419 00:15:47,399 --> 00:15:50,840 do is develop new avenues to to help 420 00:15:50,840 --> 00:15:53,179 broaden out the the number of potential 421 00:15:53,715 --> 00:15:55,795 team members, not just for us, but for 422 00:15:55,795 --> 00:15:59,335 everybody. And that probably looks at colleges and 423 00:15:59,475 --> 00:16:01,415 even younger, let's say, high schools, 424 00:16:02,595 --> 00:16:03,335 to enlarge, 425 00:16:04,355 --> 00:16:07,820 the recognition and both understanding and interest in 426 00:16:07,820 --> 00:16:09,039 these careers because 427 00:16:10,379 --> 00:16:11,039 I think 428 00:16:11,419 --> 00:16:13,660 there are folks out there wanting to go 429 00:16:13,660 --> 00:16:15,660 into this, but we also need to support 430 00:16:15,660 --> 00:16:16,399 the education 431 00:16:17,100 --> 00:16:18,160 system because 432 00:16:18,700 --> 00:16:20,320 often there are 433 00:16:20,745 --> 00:16:24,024 two, five, 10 times more applicants than there 434 00:16:24,024 --> 00:16:26,184 are spots available to train them. So we've 435 00:16:26,184 --> 00:16:27,884 got multiple different issues, 436 00:16:28,585 --> 00:16:31,485 but, you know, we know workforce is expensive. 437 00:16:32,345 --> 00:16:34,924 Replacing workforce is even more expensive. 438 00:16:35,850 --> 00:16:38,169 Keeping workforce is what we're all trying to 439 00:16:38,169 --> 00:16:40,190 do, but we've gotta make the environment 440 00:16:41,370 --> 00:16:43,529 where people feel that they've got a real 441 00:16:43,529 --> 00:16:44,029 opportunity. 442 00:16:44,570 --> 00:16:46,429 And then we've gotta be able to 443 00:16:46,889 --> 00:16:49,769 both raise awareness and actually drive folks to 444 00:16:49,769 --> 00:16:51,389 wanna be a part of this. 445 00:16:52,465 --> 00:16:54,705 That's an excellent description of the landscape that 446 00:16:54,705 --> 00:16:56,384 you're dealing with right now, Jim. I do 447 00:16:56,384 --> 00:16:58,325 wanna ask just to follow-up. 448 00:16:58,785 --> 00:16:59,285 Certainly, 449 00:17:00,384 --> 00:17:01,205 every organization 450 00:17:01,665 --> 00:17:03,665 like yours wants to build a culture, and 451 00:17:03,665 --> 00:17:05,349 I think that a lot of them are 452 00:17:05,349 --> 00:17:07,450 succeeding in some way, shape, or form. 453 00:17:07,909 --> 00:17:09,210 How do you know, though, 454 00:17:09,589 --> 00:17:12,549 beyond just what you're hearing in the hallways 455 00:17:12,549 --> 00:17:13,690 of Connecticut Children's, 456 00:17:14,230 --> 00:17:17,049 that this culture is succeeding in becoming, 457 00:17:18,150 --> 00:17:19,609 more inviting and more 458 00:17:20,394 --> 00:17:20,894 sustainable 459 00:17:21,595 --> 00:17:23,694 for clinicians and and others who work there? 460 00:17:24,954 --> 00:17:26,174 I think that is 461 00:17:26,634 --> 00:17:29,674 looking at it through multiple lenses. I mean, 462 00:17:29,674 --> 00:17:30,734 we obviously 463 00:17:31,035 --> 00:17:33,440 do feedback, We do employee, 464 00:17:34,619 --> 00:17:35,119 surveys, 465 00:17:35,900 --> 00:17:37,679 during the year as well. 466 00:17:38,140 --> 00:17:41,259 But we also get kinda direct, you know, 467 00:17:41,259 --> 00:17:45,119 leadership rounding feedback and and things that, 468 00:17:46,220 --> 00:17:48,194 our team members are saying are pain 469 00:17:48,755 --> 00:17:50,134 points. We've developed, 470 00:17:50,434 --> 00:17:52,134 you know, what we call the 471 00:17:52,514 --> 00:17:53,654 the red tape, 472 00:17:54,434 --> 00:17:56,434 work group. You know, we we have a 473 00:17:56,434 --> 00:17:58,274 lot of things that people are like, these 474 00:17:58,274 --> 00:17:58,774 are 475 00:17:59,154 --> 00:18:02,059 pains in my my my feet that are 476 00:18:02,059 --> 00:18:03,820 are I need to get the stone out 477 00:18:03,820 --> 00:18:05,200 of my shoes, so to speak. 478 00:18:05,580 --> 00:18:06,480 And we actually 479 00:18:07,180 --> 00:18:10,380 empower and allow those teams to actually help 480 00:18:10,380 --> 00:18:12,000 provide some of those solutions. 481 00:18:12,700 --> 00:18:14,240 But we also need to develop 482 00:18:14,619 --> 00:18:15,519 the the, 483 00:18:16,045 --> 00:18:19,005 you know, our our entire workforce. And whether 484 00:18:19,005 --> 00:18:21,884 that's kinda giving them that personal experience when 485 00:18:21,884 --> 00:18:22,704 they're onboarded 486 00:18:23,404 --> 00:18:27,565 to leadership development during the, you know, course 487 00:18:27,565 --> 00:18:28,464 of their career, 488 00:18:29,259 --> 00:18:32,160 We also have actually started a pilot 489 00:18:32,779 --> 00:18:34,319 for some of our leaders 490 00:18:35,019 --> 00:18:37,839 to actually, I think, kinda help model 491 00:18:38,220 --> 00:18:40,700 the the culture that we're all trying to 492 00:18:40,700 --> 00:18:41,200 achieve, 493 00:18:41,660 --> 00:18:44,000 but also to help develop it. And, 494 00:18:44,724 --> 00:18:46,404 you know, I hate to use this, 495 00:18:46,724 --> 00:18:49,125 my colleagues in HR will probably hate me, 496 00:18:49,125 --> 00:18:51,784 but what we're trying to do is avoid 497 00:18:51,845 --> 00:18:54,804 HR speak and make it be much more 498 00:18:54,804 --> 00:18:55,704 almost grassroots. 499 00:18:56,565 --> 00:18:58,804 And, you know, they know what they need 500 00:18:58,804 --> 00:19:01,680 best. They know what is most valuable to 501 00:19:01,680 --> 00:19:04,500 them. We just need to help support it. 502 00:19:05,039 --> 00:19:06,900 That makes total sense. Thank you, Jim. 503 00:19:07,359 --> 00:19:09,279 Lastly, I simply wanna ask you, as I 504 00:19:09,279 --> 00:19:10,980 alluded to before, what 505 00:19:11,519 --> 00:19:14,924 opportunities for growth you think Connecticut Children's needs 506 00:19:14,924 --> 00:19:17,105 to capitalize on in the coming year, 507 00:19:17,565 --> 00:19:20,045 five years, whatever time period you think is 508 00:19:20,045 --> 00:19:20,545 appropriate? 509 00:19:21,484 --> 00:19:21,984 I 510 00:19:22,444 --> 00:19:24,944 I think that I we're all kinda focusing 511 00:19:25,005 --> 00:19:26,065 on this, and, 512 00:19:26,365 --> 00:19:28,525 you know, I would almost put it into 513 00:19:28,525 --> 00:19:29,460 a couple of buckets. 514 00:19:30,259 --> 00:19:31,319 I would say maybe 515 00:19:31,700 --> 00:19:35,940 both the primary medical center, the quaternary hospital, 516 00:19:35,940 --> 00:19:37,960 and then kind of our more, 517 00:19:38,579 --> 00:19:40,599 community and outpatient focus. 518 00:19:41,299 --> 00:19:41,799 Internal, 519 00:19:42,375 --> 00:19:43,035 you know, 520 00:19:43,974 --> 00:19:45,994 we've got to be able to leverage 521 00:19:46,454 --> 00:19:49,494 not just our own hospital, but our partner 522 00:19:49,494 --> 00:19:50,954 hospitals as well 523 00:19:51,414 --> 00:19:54,295 and really focus on being a regional center 524 00:19:54,295 --> 00:19:55,674 of excellence and 525 00:19:56,109 --> 00:19:58,529 maybe getting those various designations 526 00:19:58,829 --> 00:20:01,710 and kind of the things that we do 527 00:20:01,710 --> 00:20:03,649 best and that I think 528 00:20:03,950 --> 00:20:04,450 are 529 00:20:04,829 --> 00:20:07,309 things that will attract people from not just 530 00:20:07,309 --> 00:20:10,690 the local area, but across regions and states. 531 00:20:11,835 --> 00:20:13,835 I think one of the examples of that 532 00:20:13,835 --> 00:20:16,315 is is work that's being done in the 533 00:20:16,315 --> 00:20:17,694 new tower right now. 534 00:20:18,474 --> 00:20:21,694 We're increasing the offerings of our oncology 535 00:20:21,994 --> 00:20:22,494 services 536 00:20:23,274 --> 00:20:24,974 and our fetal care center. 537 00:20:25,429 --> 00:20:27,349 Within the new tower is, 538 00:20:27,750 --> 00:20:28,809 state of the art 539 00:20:29,269 --> 00:20:31,289 advanced cellular and gene therapy. 540 00:20:31,990 --> 00:20:32,730 This includes, 541 00:20:33,990 --> 00:20:37,109 things including bone marrow transplant and CAR T 542 00:20:37,109 --> 00:20:37,609 but 543 00:20:38,085 --> 00:20:41,384 also includes gene therapy for muscular dystrophy, 544 00:20:41,924 --> 00:20:43,464 sickle cell and other types 545 00:20:43,924 --> 00:20:44,585 of initiatives. 546 00:20:45,125 --> 00:20:47,924 So that is much more than just straight 547 00:20:47,924 --> 00:20:48,424 oncology. 548 00:20:49,765 --> 00:20:52,140 It is actually a much broader program 549 00:20:53,420 --> 00:20:55,980 and that is actually going to draw folks 550 00:20:55,980 --> 00:20:56,380 from, 551 00:20:56,859 --> 00:20:59,279 March larger region as well. 552 00:20:59,660 --> 00:21:00,880 You know, if we 553 00:21:01,180 --> 00:21:02,720 look at the other, 554 00:21:03,820 --> 00:21:06,494 service that I mentioned inside that new tower, 555 00:21:06,654 --> 00:21:09,375 which kinda goes along with our newborn intensive 556 00:21:09,375 --> 00:21:10,434 care unit is 557 00:21:10,734 --> 00:21:12,194 the fetal care center. 558 00:21:12,974 --> 00:21:16,974 This center actually provides care even prior to 559 00:21:16,974 --> 00:21:17,474 birth. 560 00:21:17,934 --> 00:21:20,115 And because it is a full service, 561 00:21:21,160 --> 00:21:22,380 fetal care center, 562 00:21:22,680 --> 00:21:25,720 these babies with complex anomalies can actually even 563 00:21:25,720 --> 00:21:27,980 begin treatment often surgically, 564 00:21:29,079 --> 00:21:30,220 prior to birth. 565 00:21:31,079 --> 00:21:33,099 And then obviously once, 566 00:21:33,775 --> 00:21:36,335 a patient is born especially if they may 567 00:21:36,335 --> 00:21:38,734 not need surgery prior to birth, we have 568 00:21:38,734 --> 00:21:41,234 the full surgical suite and subspecialty 569 00:21:41,615 --> 00:21:42,115 care 570 00:21:42,414 --> 00:21:44,894 services that are available to that mom and 571 00:21:44,894 --> 00:21:45,875 to that child, 572 00:21:46,859 --> 00:21:48,480 immediately after birth. 573 00:21:49,420 --> 00:21:50,160 I think 574 00:21:50,619 --> 00:21:53,580 that helps kind of, you know, distinguish us 575 00:21:53,580 --> 00:21:54,080 from, 576 00:21:54,859 --> 00:21:56,559 you know, many others and, 577 00:21:57,259 --> 00:21:59,684 you know, with centers of excellence in rare 578 00:21:59,684 --> 00:22:00,184 bone, 579 00:22:00,484 --> 00:22:00,984 hematology, 580 00:22:01,285 --> 00:22:02,505 oncology, and others, 581 00:22:03,285 --> 00:22:05,605 that's really where we're going to focus kind 582 00:22:05,605 --> 00:22:07,384 of on the inpatient side. 583 00:22:08,164 --> 00:22:10,644 On the outpatient side, we really need to 584 00:22:10,644 --> 00:22:13,285 leverage that regional care and the care close 585 00:22:13,285 --> 00:22:14,345 to home model. 586 00:22:15,279 --> 00:22:16,900 You know, focusing on expanding 587 00:22:17,599 --> 00:22:18,740 and maybe strengthening 588 00:22:19,039 --> 00:22:20,660 our adult partner locations, 589 00:22:21,599 --> 00:22:23,619 but really also on our ambulatory 590 00:22:24,000 --> 00:22:24,500 services 591 00:22:25,519 --> 00:22:28,240 and locations that are actually outside the main 592 00:22:28,240 --> 00:22:28,740 campus. 593 00:22:29,474 --> 00:22:31,494 Sometimes actually quite far away. 594 00:22:32,515 --> 00:22:34,454 You know, while many of the financial 595 00:22:34,755 --> 00:22:37,174 pressures we're up against are not easily 596 00:22:37,474 --> 00:22:37,974 fixed, 597 00:22:38,595 --> 00:22:39,974 you know, we can actually 598 00:22:41,490 --> 00:22:44,130 do our part to provide care at the 599 00:22:44,130 --> 00:22:44,630 right 600 00:22:44,930 --> 00:22:45,430 location 601 00:22:46,210 --> 00:22:48,549 with the right services at the right time 602 00:22:49,170 --> 00:22:51,410 and actually hopefully do it in a more 603 00:22:51,410 --> 00:22:54,769 cost effective manner. So whether that's providing urgent 604 00:22:54,769 --> 00:22:55,269 care, 605 00:22:55,644 --> 00:22:56,785 ambulatory surgery, 606 00:22:57,484 --> 00:22:58,545 specialty care. 607 00:22:59,804 --> 00:23:01,184 More and more care, 608 00:23:01,484 --> 00:23:02,625 pediatric especially, 609 00:23:03,244 --> 00:23:06,845 is moving more outpatient than inpatient, and we've 610 00:23:06,845 --> 00:23:08,970 gotta be where the patients are, 611 00:23:09,529 --> 00:23:11,289 but we've gotta do it in a manner 612 00:23:11,289 --> 00:23:15,230 that is sustained. And having twenty, thirty different 613 00:23:15,369 --> 00:23:18,569 people providing that care is not, you know, 614 00:23:18,569 --> 00:23:21,710 financially good sense. We wanna be able to 615 00:23:22,275 --> 00:23:24,215 partner with other organizations 616 00:23:24,914 --> 00:23:28,195 to be their preferred per pediatric provider. Say 617 00:23:28,195 --> 00:23:29,494 that three times fast. 618 00:23:29,955 --> 00:23:30,455 And, 619 00:23:31,394 --> 00:23:34,434 also be able to, you know, provide that 620 00:23:34,434 --> 00:23:36,455 care to the families that we serve 621 00:23:37,059 --> 00:23:39,480 now in three states across our region. 622 00:23:40,420 --> 00:23:42,500 Jim, thank you so much for everything you've 623 00:23:42,500 --> 00:23:44,259 been able to share with us today on 624 00:23:44,259 --> 00:23:46,259 the podcast, and we look forward to seeing 625 00:23:46,259 --> 00:23:48,660 you at our conferences coming up later this 626 00:23:48,660 --> 00:23:50,820 year. And, yeah, we look forward to any 627 00:23:50,820 --> 00:23:51,132 time, 628 00:23:51,692 --> 00:23:52,592 paths cross. 629 00:23:53,052 --> 00:23:55,692 Chris, I really appreciate the opportunity. Thanks so 630 00:23:55,692 --> 00:23:56,192 much.