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This is Laura Dedo with our
Becker Healthcare Podcast.

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I'm thrilled today to be
joined by Dr. Shazad Saed,

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associate Chief Medical Officer in
pediatric gastroenterologist at Dayton

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Children's. Dr. Saed, it's a pleasure
to have you on the podcast today.

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Thank you, Laura. Um, and thanks for
the invitation to join, uh, you in, um,

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sharing some of the
perspectives. Um, I'm, um,

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thrilled and honored to
share my perspectives on,

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on the topic list that
we'll talk about. Um,

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I'm a pediatric gastroenterologist
by background with, uh,

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a focus on children with Crohn's and
colitis and have a quality improvement

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background, um, uh, which is
focused on improving the cost,

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the care and quality of
children With I B D. Um,

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I am involved in an international
collaborative that, um,

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is a quality improvement collaborative,
known as improved care now,

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and we really work, um, in
a co-production model, uh,

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partnering with researchers,
patients, families,

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and other clinicians to really
focus on improving the, uh,

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the standard of care for children
With I P D and my hospital role, um,

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I am involved in, um, uh, uh, the,
the patient and family experience,

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uh, area as a physician lead. Um,

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we have really utilized the quality
improvement methodologies to look at our

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patient experience data to make sure that
we deliver exceptional care for every

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encounter,

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whether that be in the ambulatory
setting or in the inpatient setting. And,

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um, along with that, um, I'm, uh,

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in my role as the Associate Chief
Medical Officer. Um, I am, um,

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involved in two to three, uh,
service lines in the hospital, um,

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responsible for some of
the, uh, access growth,

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patient experience and quality metrics,
uh, for those service lines, uh,

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which in include about 14, 15
different divisions. Additionally,

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um, we are trying to
really focus on, um, uh,

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embedding quality improvement, safety
and quality in our operations. So I also,

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uh, am involved in a, uh, the
group of, um, um, folks or in, uh,

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projects and initiatives, um,

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which are bunched under the
umbrella of clinical excellence,

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which aligns quality,
quality improvement, safety,

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quality assurance, uh, and informatics
to make sure that we have, uh,

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laser sharp focus on what is driving
our strategy and activities, uh,

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uh, based on our strategic roadmap.

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How that's, you know,

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just really impressive to think about
and hear all the things you have your

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hands in today,

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from the top level strategic aspects of
affecting patient care right down to the

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things that you're doing in the
patient visits and operating rooms. So,

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I'm excited to hear about that. And
I'm wondering, given all of this,

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what issues are you spending
most of your time on today?

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What are you excited about tackling and
really doing to improve patient care?

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Thank you, Laura. It's, it's,

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it's a great question to sort of delve
deeper into what our, um, focus has been.

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And like everybody else, we have
been, uh, dealing with, um, um,

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opportunities for really buffing
up our, uh, staffing, um, status.

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Um, we have been really, um, uh,

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intentional about how we
are trying to manage, um,

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staffing in critical areas, um, uh,

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and looking at that staffing model
from a wellness and resilience

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perspective as well, uh, which is,
uh, uh, aligned and, and, and, uh,

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connected. Um,

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as with most healthcare, uh, systems,

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financial sustainability is also,
um, uh, very sharp, um, and,

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and laser focus for us
because we can't, um,

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underpin our staffing and resilience,
uh, processes without having, um,

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insights and, and ability to
financially support them. Um,

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as we have also recognized that, um,

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patient experience and
experience of delivery of care

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is tightly, uh, connected with, um,

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resilience and wellness of our staff, we
are also paying very much attention to,

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uh, ensuring that, um, the patients
that are touching our health system, uh,

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either in the, in the inpatient or
in the ambulatory or emergency, uh,

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room setting, continue to receive the,

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the exceptional care that they
expect and deserve to receive. Um,

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in view of some of these
challenges and opportunities, um,

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we are also thinking about how
to leverage technology, um,

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and virtual care to optimize the
clinical operation. And as well as, um,

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not only optimizing, but also thinking
outside the box to see, uh, what kind of,

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um, technological, um,

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leverage we can utilize to,
um, deliver care. For example,

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in the past, if, uh,

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a staff person or a nurse
was managing chronic disease

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patients,

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are there opportunities from technological
support perspective that can help us

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manage some of those things and offset
some of the staffing challenges that, uh,

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that we are facing? The other
area that we are sort of, um,

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paying really, um, close attention to, um,

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is behavioral health and
mental health strategies. Um,

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like everyone else, we have seen a,

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a huge, um, number of increases in,

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in our behavioral health
patients and, and, and even, um,

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staff, um, who are dealing
with a lot of stressors.

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So we have really developed a
behavioral health strategy to, um,

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think about how to deliver needed care
and support for our patients as well

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as staff. We are, um,
investing in building a, um,

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a new, um, be health, uh, building, uh,

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expanding and almost doubling our
inpatient behavioral health beds, uh,

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for pediatrics, uh,

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to really coordinate and
try to integrate a lot of

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the behavioral health, uh,
activities under one roof. Um,

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and also recognizing, uh,
the, the need that is, uh,

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growing up, um, by the
day in our community. Um,

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I'm not sure that your audience, uh,
is aware, but, you know, pediatric and,

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and children in the midst of this
pandemic has have really, um,

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been at the forefront of the
mental health crisis and, um,

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the rates of depression, anxiety,
uh, and, and suicide, uh,

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ideation has really, uh,
mushroomed in the last few years.

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So a lot of the pediatric healthcare
systems are, um, having to deal with, uh,

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uh, these kind of, uh, challenges and
how to sort of, um, uh, structure them,

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their operations to meet these
challenges and in fact, um,

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prevent some of these
challenges from happening.

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The last area that I would sort
of, um, share about, uh, uh,

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with, with audiences, um,
health equity, um, you know,

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the last couple of years
have really shown a, uh,

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light on opportunities for improving, uh,

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the delivery of healthcare, um,
systems to, uh, patients with,

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uh, different backgrounds. Um, and, uh,

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like most health systems, we are, um,

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really realizing the
opportunities that exist, um,

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in our operations to think about
different aspects of our community that we

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serve. Um, like most pediatric facilities,

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we are an anchor institution,
and we need to be very, um,

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sensitized to what are the needs of the
community that we serve, and also, uh,

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bring that health equity,
uh, lens to our operations,

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our quality improvement projects,
our utilization projects.

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So I'm really, um, uh,

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glad at certain levels
that those kind of, um, um,

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focus areas are coming
to the fore. Um, uh, and,

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and I look at it as an opportunity which
is stemming out of a potential crisis

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from the pandemic.

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Yeah,

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I think all of those are
really interesting points
in terms of looking at how

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virtual care and telehealth works in
the pediatric space and what kind of

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platforms need to be built
out there. But then to your,

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your point on the behavioral health aspect
of things, I, I think is so crucial,

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as you mentioned,

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for us to really understand and
find solutions for some of the, um,

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ballooning rates of, as you mentioned, um,

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anxiety and suicidal ideation and all
these other things that are really

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a huge, huge challenge for the pediatric
population today. Um, you know,

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when you look at some of these rates
increasing in the trend toward, you know,

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needing more of these behavioral health
visits and specialists and, and, um,

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tackling these problems, how do you
see tho those solutions coming up?

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Is there anything that can be done
in the short term versus long term?

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How are you thinking about that?

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I think, um, we need to probably
have both short and long term,

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um, strategies, um, put in place.
I think the short term, obviously,

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is meeting the acute care,
acute care needs, uh,

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from the mental health perspective,
um, staffing providing, um, um,

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counselors providing, um, support, um,

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to those who are in, in,
in acute, uh, crisis, um,

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and managing and, and, and, uh,
and empowering them to sort of, um,

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then get better and then probably
pivot to a more longer term strategies,

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which would include, again, um,

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partnering with the community to make
sure that when they are out of the health

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system, they have all the support
that they can get and need, um,

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leveraging community
health workers to, um, uh,

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help the community tackle with some of
these, uh, issues. There's obviously,

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um, in my mind a potential, you know, uh,

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health equity lends to these
mental health crisis as well.

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Access to support services, access
to, uh, treatment facilities,

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um, transportation, uh, food security,
all of that sort of comes into play,

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um, uh, as, as a long-term
strategy. Um, and, um,

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I think as, as a society, we really
need to start thinking about, um,

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how to pivot, um, and think about, um, uh,

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a preventive way of managing
some of these crisis,

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which then, you know, if
not adequately addressed,

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then lead to more acute short-term
needs for, uh, support services.

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That's a really excellent point. Thank
you so much for going through that, Dr.

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Saed. Now,

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when you think about these challenges
as well as everything else going on in

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healthcare today, um,

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what are you thinking about in terms of
investments in growth over the next two

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years?

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Where do you really see your practice
as well as Dayton Children's headed?

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I think, uh, I had shared, uh,
about the new building, uh, sort of,

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uh, that we are investing
in to really, um,

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have an integrated strategic approach to

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providing all sorts of mobile
health services under one roof, uh,

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which would in expand
our inpatient footprint,

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but also our crisis center
day treatment center,

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um, staffing, um,

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as well as counselors and
psychologists and psychiatrists, um,

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investing in, in developing an
eatin disorders program, both as,

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as an inpatient, uh, uh, service,

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but as well as as outpatient
ambulatory service as well.

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So that's a real large
focus of our, um, uh,

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strategic plan and investment
on the last couple of years.

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We hope to have the new building, um,

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stood up by mid 2025, so,

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which is in co in two to three
years time. The second, uh,

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big investment, I think,

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and growth opportunity at the same
time is really thinking about, um,

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care coordination, um, handoffs between
inpatient and outpatient settings.

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How do we optimize that to prevent,
um, you know, readmissions,

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opportunities to really connect with, uh,

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the patient's care between, um,

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a specialty based service
model to a primary care,

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uh, model that is, uh, the right venue
for delivering a lot of the care,

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which can also then help us,
um, look at and, and, uh,

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really think about, um, uh,

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providing care in the right setting
to reduce the cost of care. Um,

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value-based care, uh, we have been in
that area for the last four to five years,

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um, and have made a lot of progress,

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but I think pediatric
facilities have been, um, uh,

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lagging hand adult facilities
in really thinking about the,

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the value-based care model and how to
sort of think about, um, driving value,

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um, uh, and, and partnership with
community physicians, community part, uh,

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community, uh, uh, care providers and,

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and pairs to really, uh,

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drive cost down. Um,

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the third opportunity
that I would think, um,

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that is having us think about
investment is again, um,

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uh, technological platforms
and, um, and virtual care.

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What are the opportunities that we
can partner with, um, some of our,

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um, uh, technology partners to
really think about data driven,

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um, technological solutions
that can help, uh,

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streamline operations but also reduce
cost, but provide exceptional, um,

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care experiences for our patients
and customers, um, and their,

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their opportunities exist in, um, uh,

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in sort of virtual health
too. But, you know, uh,

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virtual reality mitigating,
uh, anxiety and, and, and,

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and depression. We actually have, um, uh,

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special sensory rooms in our periop
and, uh, couple of other settings where,

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uh, patients with special needs
can really, uh, uh, receive,

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uh, special treatment and, um,

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has really led to reduced, um,

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sedation requirements and
sedation medication for some
of these patients who are

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scheduled to undergo
procedures. And again, uh,

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amplifying those kind
of things for our, uh,

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rest of our patient population
is another area of, uh,

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growth and investment for us. I
think, um, care coordination, um,

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amplifying our, um, partnership
with, uh, our, um, um, aco,

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um, and community to
really think about, um, uh,

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growth opportunities and investment in
that area. And of course, I think, um,

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I previously alluded to
the health equity piece,

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and we have sent stood up a
center for health equity, um,

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and are really looking at, um,
you know, uh, our ed visits,

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ed, uh, readmission rates, uh, we, um,

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trying to think about what
kind of services we can
provide to patient population

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of disparate backgrounds, um,

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partnering with community to really
deliver some of those resources in their

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neighborhood rather than having
them come to the hospital,

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we have stood up a food pharmacy
to look at food insecurity.

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So some of these are some of the things
that we are really focusing on investing

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on for the future, um, short-term period.

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Got it. I think that's so
helpful to know, you know,

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and really interesting to
think about some of the,

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the short and long-term investments
that you have and how those fit into the

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overall strategic plan. Now, I
think before we sign off here,

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I wanted to ask one more question.
What are you most excited about today?

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I think that's a, that's
a great question. Um,

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I think all of us are feeling after,

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after effects of two to three
long years of pandemic and, and,

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and the effects of it. I also feel
that this is really a, potentially a,

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a op opportunity to reset.

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We really need to sort of
think about how we operate. Um,

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the,

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some of the challenges that we sort of
talked about are not gonna go away in the

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sh in, in the near feature.

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So how do we repivot ourselves
to think about how are we gonna

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leverage some of these opportunities
to streamline, augment,

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amplify, empower our, our
operations and benefit, um,

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not only to patients and families, uh,
but also some of our staff members,

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colleagues. Um, I think
this is really, um,

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allowing us to think deeply
about the wellness piece of, uh,

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of our operations for our staff and for
our patients as well. And, and I think,

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um, uh,

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healthcare system that is really
focusing on that will really be the

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healthcare system of the future. Um,

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you can't deliver exceptional care if
your staff is not exceptionally well care

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for. So I think, um, this is,

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this gives me energy and this gives me
excitement to see how what the next phase

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of healthcare, uh, system would,
uh, spring out of this, this, uh,

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challenging time.

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Well, Dr. Sayed, I think
that's a great point.

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Thank you so much for joining
us on the podcast today.

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It's been a fascinating discussion and
I look forward to connecting with you

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again soon.

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Thank you, Laura. Um, I wish
everybody a great rest of the day. Um,