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This is Chris Os with the
Becker's Healthcare Podcast.

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I'm thrilled today to be
joined by Chanda Chak,

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CEO of Children's Hospital and
Medical Center in Omaha. Chanda,

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thank you for joining us today.

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Thanks. I'm really
excited to be here today.

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Excellent.

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Could you please introduce yourself and
tell us a bit about your background?

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Absolutely. I'm Chanda Chaco,

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I'm the president and c e o here at
Children's Hospital and Medical Center in

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Omaha. And I have always
been in pediatric healthcare.

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I started my healthcare career at Texas
Children's Hospital in Houston and

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was there for 14 years doing
a little bit of everything.

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I started as an administrative fellow.

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I was in pharmacy ambulatory operations,

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the fetal center, the heart
center, the maternity center. Um,

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I went out to our West Houston community
campus in the end of my career and then

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headed to Arkansas Children's in Little
Rock and was the chief operating officer

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for the system there. And really was,

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had a great opportunity to do and use the
skills I'd learned at Texas Children's

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that we had done really in a citywide
level because we were 4 million people in

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Houston, uh, then across
the state in Arkansas.

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So it was a great
opportunity to scale, um,

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my experience to a statewide view and um,

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in a state that had challenges in
child health and also had a lot of

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rural, um, environments and so learned
a ton there. Was there for four years,

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um, was really a great
experience. Learned quite a bit.

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And then joined the children's team
here in Omaha in September of 2020,

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uh, right during the pandemic.

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What would you say are the
biggest challenges in scaling
up as you referred to,

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and how did you overcome them?

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Yeah, it's perspective.

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And so I think the skills that
I learned in Houston in an urban

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environment that was, um,

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really densely populated gave
an a unique perspective of,

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um, what the tools could be and
what the potential solutions were.

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And then moving to a state
and looking at um, you know,

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rural areas and different, um,
components of the community.

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The same skills really for
me, um, stood out. It was the,

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how that was different.

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So when you're going into a rural
community in say southeast Arkansas,

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um,

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it's important to connect with the people
and not come in as the big children's

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hospital to say, here's how we can help
you, but really engage the community.

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And I, I think for me,

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that focus on people has been something
that's been important part of my career

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from the very beginning.

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And so it was really looking at all these
opportunities we had and what was the

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community interested in. And so, um,

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for me it was really a
great opportunity to um,

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really see how solutions in one
large urban environment might not

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exactly be the same thing that is
needs to be in a rural um, environment,

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but certainly gives a place to
start to have the conversation. So,

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um, for me it was just an
awesome opportunity to get
very focused on building

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relationships that, um, were across
the state versus across the city.

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I will tell you,

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Houston takes forever to drive across and
so it probably took me the same amount

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of time to drive across Houston as
it did driving from little Rockton,

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Northwest Arkansas.

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<Laugh>. Uh,

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given your perspective now as c e
o there for almost three years, uh,

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what would you say are the biggest
issues you're following right now?

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Gosh, you know,

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it's issues and opportunities because I
certainly think in healthcare we're such

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a dynamic environment
and we have to be nimble.

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What I've seen happen in the last
couple of years since I've been here at

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Children's is just the,

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the people market has changed so
dramatically where in healthcare,

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the more than 20 years
I've been in healthcare,

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we've always seen nursing
staffing via challenge.

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What we're seeing now is it's across
the entire healthcare system in lots of

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roles.

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And so it's really pushed us in
healthcare to be more agile and nimble

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in focusing on our, our people.

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And that's to me the biggest
part of the work we do.

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And we're more competitive now across
other industries where historically,

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you know, people who wanted to work in
healthcare really flock towards that.

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Were having to use much more unique
strategies for retention and wellbeing of

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our own team members and also to help
attract people into healthcare that might

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not have thought that that
is an opportunity for them.

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And really help people either develop a,

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why they want to be in healthcare or
just be the kind of company that's

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competitive with the bigger companies
that are not healthcare related.

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And people say, gosh,

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at Children's they offer really great
benefits and they are very focused on

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wellbeing and it feels like they care
about me as an individual and that's what

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attracts people in. And we've had
to be much more agile with, um,

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that thinking.

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And I think that's very exciting
in looking at how we build teams,

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how we build models of care and
really pushing our thinking around

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maybe something that's been the same
thing we've done forever in healthcare and

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we have to think about it differently.
I find that really energizing. Um,

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and it's been very energizing for our
team to be able to say, there's no box.

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You have to think within it. Just,
just think of the best solution.

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So I see that the people
part of our work, um,

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as probably the biggest challenge that
we're all facing. And it's not just,

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you know, I don't call it staffing cuz
it's more important to me than that.

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It's really about how
we retain great people,

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how we develop the p
the workforce pipeline,

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the next generation of leaders for
the future that are already at our

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organization. So I think
that's pretty exciting.

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I'm gonna use that right there as a segue.

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So what else energizes you as far as
being competitive or retaining staff and

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people or connecting with your community
and what makes you a little bit

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nervous?

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Sure. Um, let's see, what else
makes me excited? Innovation,

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I think you spoke to Ryan Cameron,

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a executive on our team and
it was intentional that we
doubled down not only on

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the people promise that we have for our
own team members and the patients and

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families we serve, but on investing
in innovation. And if, um,

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there's not a lot of dollars on the
healthcare innovation pipeline that are

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invested in pediatric healthcare because
we are such a diverse population,

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right? We're from birth
until 19 and sometimes older.

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And so it's,

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it is a difficult business proposition
to invest in innovation when

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our population is so diverse just
on age size, all those things.

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And so we knew we would
have to be very, um,

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purposeful in our work around innovation
because the patients and families we

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serve really deserve us
to be excellent. And um,

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so we had to really focus on how
we were going to elevate that work.

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And that for me is kind of exciting
and also certainly a little bit in

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intimidating when you think we're in
the same game with really big innovative

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companies. The difference for me is
that we know our population really well.

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We have a very tight relationship with
our team members and they are really

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smart and have really great ideas of
the work we could do to do this work

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better. Not just from a research
side, but a day-to-day work, right?

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How do we think differently and really
expand the horizons of things that may

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never have been done in healthcare
but could propel the work we do,

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the efficiencies we have.

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And that for me is really exciting to
think about what healthcare will look like

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five years from now. Uh,

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we changed a lot during Covid and
we're forced into that real digital

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space. And now like we talk
about digital innovation,

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it's just part of our language
now and that feels exciting.

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We have tons of data and
information in healthcare.

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How do we use that in our organizations
to help us be more efficient and

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effective in the work we do?

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I think that's not only the right
thing to do for the care we provide to

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patients and families, but it's
also right for our employees, right?

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If I knew my employer was helping
intentionally focus on innovation to make

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my work easier, more effective,
that feels pretty exciting.

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I wanna be a part of that. And so
I'm really looking forward to how um,

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we are gonna,

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how the industry and how we specifically
here at Children's will look five years

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from now and how we do our work.

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I love how you said there is no
box. So as you look forward in the,

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to the next 18 months or so,

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how do you anticipate your roles gonna
change and how are your team teams going

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to have to change?

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Yeah, I have spent a lot of time
in the past year and you know,

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focusing our team on how
important it is to remember that

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healthcare and healthcare organizations
only provide about 20% of health

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to people. 80% is determined
outside of our walls.

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And so we have really shifted our
focus in the work we do to also

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include that 80% outside of our walls
and how do we partner differently more

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effectively and how do we really refine
our work to not not be that sort of big

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brother idea of coming and
saying do it how we want to,

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but really standing side by side
with organizations in the community,

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with schools, with
community partners to say,

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you're already doing really great work.

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How do we help you go faster and go
bigger and not need to smack our logo

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on it? Right? For me,

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doing the right thing in child health
and making an impact in child health is

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the right thing to do regardless of logos.

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And I think credit comes
where partnerships happen
and that's how people talk

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in communities. And so for
me, you know, my time is, uh,

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progressively more spent
externally to the organization, um,

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are still a hundred percent our
focus. Our core mission is, uh,

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providing great healthcare to families,

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but our mission at Children's is
to improve the life of every child,

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not just the health. And to be
able to do both those things,

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we have to be external.

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And so our team is spending
more time building partnerships,

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building relationships in the community,
in regions and in the national front.

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And I only anticipate that's
gonna increase as we realize
how integrated we are,

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um, here in our community,
but just really, uh,

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further out and those relationships and
partnerships help us solve big problems

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like mental health, right,

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or child abuse that's not gonna
be solved by one organization.

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It's gonna be solved by us partnering
together to do the best thing for kids.

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As far as building relationships
and building a strong community.

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And you're a part in that.

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You've advocated for kids and foster
care as a support appointed special

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advocate, which is terrific.

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So how has that influenced your
leadership style first and foremost?

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Oh gosh, it is, um, probably the most
impactful thing I've done in my life.

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Um, I don't have my own children, uh,

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biologic children and so this was my
way to make an impact personally in

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kids' lives. And I remember when I
was in Houston, everyone would say,

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I don't know how you have
enough time to do that work.

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And I think you make time for
things that are important.

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And my dad used to tell me as
a, as a little kid when, uh,

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you're really full ice
cream always fits in,

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it fits in the little
open places for dessert.

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And I see child advocates and being a
court appointed child advocate as that

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kind of work for me. Um,
I have served over, gosh,

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over 15 kids that have been in the
system and have relationships still with

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several of them and really
feel, uh, personally gosh,

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honored to have been able to be a
part of their journey and to see how

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successful they've been. And for me,
that's the personal part of leadership.

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It's why I'm in pediatrics is for
the impact that we can make early in

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kids' lives and in families' lives
that help change their memories,

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change their trajectory for the
rest of their life. And I just,

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I feel really honored that I got to be
in the journey with these families and

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these kids who, um,

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gosh taught me as much as I taught
them, if not more. And that's, uh,

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been real powerful for me to realize
that individuals can make a really big

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impact.

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And that's a big reason why I came
here to Children's in Omaha is because

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this is the kind of place,

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this is a size of city where individuals
can still make a really big impact.

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And the community here is
very nimble, moves quickly,

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partners really rapidly.

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And that for me is an exciting place
to be when we can see big work and big

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shifts happen really rapidly. Cuz
if it's the right thing to do,

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we shouldn't stand in the way of
ourselves waiting to be perfect when we're

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missing the excellence that's just gonna
pass us by if we don't move. So, um,

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I've loved being a court appointed
child advocate. It was, as I said,

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PR really probably one of the pieces of
my life where I think I've been the most

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impactful.

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Zooming out on that subject a little bit,

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how connected do you think the healthcare
system in your hospital and healthcare

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system in particular is connected to
foster care and where do you see room for

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improvement?

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I do think that, um, many children's
hospitals as we are here, um,

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in Omaha are very tied to the state, um,

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c p s teams, child teams. It's,
it has been every place I've been,

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it has been a really tight partnership,

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a really close partnership
at the state and city level.

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And that's powerful because healthcare
sometimes is one of those pieces that can

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fall off, um,

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of the radar in those kind
of shifts and transitions.

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And I see that as a really unique role
of children's hospitals to provide care

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for some of the most vulnerable kids
who are in foster care. And we've,

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every place I've been has done
a really great job of, uh,

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partnering in Lincoln and I think those
relationships and partnerships have to

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be fed and watered, right? They have
to be grown to make sure that you,

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um, shift and modify your work based
off the needs of this very vulnerable

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population. We've seen that
shift here and during C O V D of,

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not surprisingly the increase in need
for mental health services in the this

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patient population.

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We've seen that across pediatrics
and it's no different in our,

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the kids that we see that are in
the foster care system. And so, um,

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as we've said about many of the things
we do, we don't do that in a vacuum,

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we don't do that alone.

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We do that through partnerships of the
child advocacy centers that are in our

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community here, um, and work
really closely with them
to say, how do we partner?

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How do we do the right thing? And I,

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I do believe you have to ask those
questions because what we believe is

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important or helpful from the children's
hospital side might not actually be

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what those organizations need to help
provide the very best care for children in

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foster care. And so those conversations
in partnerships are powerful. Um,

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for me, so powerful. I actually serve
on the board here of Project Harmony,

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which is one of our child
advocacy centers. Um,

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for me it's really important that
there's that connection between our

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organizations so that we can be nimble
and agile for kids that didn't ask

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to be in the foster care
system. Um, and we should,

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we should have a responsibility
to do the very best work.

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Last thing I have for you today, Chanda.

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So what issue in your field do you think
deserves a much brighter spotlight than

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it's getting right now?

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Oh gosh. I think, I mean,

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I think both of the things that I would
think about are getting a pretty bright

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spotlight. There's not
an easy answer to them.

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I would say the first one in pediatric
healthcare is around behavioral and

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mental health.

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And we are shining a very bright light
on that here in Omaha and Lincoln

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in the region here in Nebraska because
we know it is so critical to the future

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of our state to the future, uh,

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people who are gonna be working across
our state. And so we've intentionally,

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um, really doubled down on that work,

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working across the community with
state and local government, um,

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with donors in the community,
with our team members,

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with community partners in schools.
And we'll be investing, uh,

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breaking ground actually this August
on a facility through the help of the

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Mental Health Innovation Foundation,

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which is a foundation started here in
Omaha to invest in a facility that will

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have a full continuum of mental
and behavioral health from, um,

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the very least acute to
an urgent care center,

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to a partial hospitalization
to inpatient psychiatric beds,

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will also embed primary
care in this facility.

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And it's intended to be the hub to
create a hub right here in Omaha to

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then create spokes across the
state. As being a rural state,

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we have to think of creative solutions
to help providers and kids stay close to

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home.

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And so we're doing a lot
of work on education of
providers implementing some new

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really innovative care models through
telehealth and through partnerships with

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primary care providers in, uh, across
the state. Also looking at urgent care,

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mental health centers so that we can
help really deescalate as quickly as

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we can and then also have that spoke
back into this highest acute care

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that we'll uh, be delivering right here
in Omaha and our, uh, central campus.

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And that's,

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that's really important work
because there's so much linkage to

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long-term outcomes, long-term
health, um, with mental health.

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And we've seen such an increase in, um,

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kids coming to the emergency department
for suicide ideation, uh, depression,

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anxiety here in Nebraska.
We have a higher, uh,

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rate of suicide than the national
average for at teens and adolescents.

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And that for me is one of those things
that keeps you up at night. You know,

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when when I can sit in, be in
a hero walk for a child who,

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um, has successfully passed from
suicide, it makes you think, gosh,

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I know people on my team know this child
and know this family and this is not

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okay. We have to do better.

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That shouldn't happen here or anywhere
and we gotta get ahead of that curve and

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we're chasing it, to be honest.

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And so I would love to shine a
brighter spotlight, um, on that.

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I think there's a pretty big
spotlight on it right now, but, um,

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it is something we're definitely chasing
and, um, not yet ahead of that curve.

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So for me that's, uh, probably the most
important work we have ahead of us.

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Shannon,

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thank you so much for sharing your
insight today and giving us your time.

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We can't wait to share all your
insight with our listeners.

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Awesome. Thanks so much.