Speaker 0: This is Laura Dierda with the Becker's Healthcare podcast. I'm thrilled today to be joined by doctor Paolo Ferrata, who's the chair of the department of surgery at Inova Fairfax Medical Campus and system division chief for trauma and acute care surgery at Inova Health System. Doctor Farada, it's a pleasure to have you on the podcast today.

Speaker 1: Laura, the pleasure is online. Thank you so much for having me.

Speaker 0: Absolutely. Well, I'm excited for our discussion because I I know, you know, there's so much happening at, Inova, and especially looking at clinical care. It's just a time right for innovation. So I'm looking forward to diving in. But before we do, I'm wondering, can you introduce yourself and tell us a little bit more about Inova Health System?

Speaker 1: Yes. Yes. So my name is Parda Perata. I am the chair like you said, the chair of the department of surgery at Inova Fairfax Hospital, which is our flagship hospital. We have over 900 licensed beds, although we take care and serve more than, those patients.

And we are located in Northern Virginia to serve a population of 3.2, million, people. We have the third busiest emergency, room in the entire country. And, the department of surgery, we need more than 90 surgeons from different specialties, all cutting edge, very, very interesting and very talented group of physicians. And from the trauma perspective, we have a trauma system. So we have a level one trauma center in Fairfax Hospital.

For those of you that are not familiar, what does that mean, level of trauma center could be level one, which is the highest acuity. Level two, same clinical acuity, but without research and residence. And level three is less acuity, and then their other levels are not, recognized by the state or the American College of Surgeons. So we have a level one in Fairfax, and we have a level two in Loudoun. Beautiful hospital.

Great teams. Very capable clinicians. In terms of my background, I have been working in IEnova for four years. Before, I was, at another at Virginia Commonwealth University where I was the director of the ICU and professor of surgery and director of the fellowship. And I trained, residency at the Beth Israel Deaconess Medical Center in Boston and did, an extra year of training in the University of Pittsburgh's critical care and trauma and an extra year of acute care surgery at shock trauma in Maryland.

And, I have been practicing as a surgeon since 02/2008. So that's that's my background. In terms of leadership, I think that, I have done, I have taken several courses and and learned a lot, mostly from experience and from being surrounded by an amazing team and great leaders. And so I consider myself lucky in my leadership journey. We'll continue to grow and stretch as we go.

Speaker 0: Absolutely. I I think that's great to hear and and definitely inspiring to know, how you've, you know, gotten to the point where you're at, from being practicing clinician into more of this leadership role. And could you expand a little bit more on your leadership philosophy? I know grounded in the principles of butter level five leadership. Could you talk a little bit more about that and what your focus is now in driving long term success within the organization?

Speaker 1: Yeah. That's a great question. And, and, and I thank you so much for asking me that. I think that I I got a, a junior faculty asking me this in one of our lunches last week. Why did I go into leadership?

Because we all have to have our purpose clear and our why. Right? And I was like, I was never really hungry for power recognition, but it was more that I saw what poor leadership does to the team. I saw what poor leadership how it trickles down to everybody, how toxicity actually can destroy teams. And even though, we think it's just for the positions, everything else everything that we do in terms of leadership or, clinical care or anything that we do in in a hospital ultimately touches patients, and, whether we want it or not.

So I think that why did I get in leadership and and training myself and surrounding myself with people that I wanna emulate and, and doing everything that that I think I dedicated my life to doing the last decade is because I wanted to, make surgery particularly, but also health care a place where we can speak up, that we can, mentor each other, we can protect each other, we can help each other, But we're allowed to be vulnerable with each other and where, we obviously try our best to prevent mistakes. But when mistakes happens, we avoid blaming and shaming people, but actually understanding failure as a learning opportunity where we have know that we have each other's best interest at heart. Nobody in any health care system shows up to the hospital to harm somebody. We are healers, and so I think that that is the reason why I got in. That is the reason why I train myself.

I love I'm very passionate about leadership. I read something about leadership almost every every day. But I think when we're talking about level five, leadership, it's not only about learning yourself, be your best self, changing the environment, but the capacity of mentoring other people to be leaders as well. To, make a change and to leave a legacy of trust in each other as a team where people feel safe speaking up, where people feel that we belong. So that is, my leadership philosophy and that is my why.

Speaker 0: That's amazing to hear. Thank you so much for sharing with us and being very candid about your journey into leadership. Now I'm curious. Can you share any, specific examples or or things you're most focused on right now when you're looking at applying this leadership in some of the results that you've seen from it?

Speaker 1: Yes. Yes. Thank you. So I think that I, so I came from I'm I'm a foreign graduate. I was born in Colombia, South America, and it's incredible.

We go straight from high school to medical school. So I started I started medical school when I was 16 years old, and I had the opportunity of seeing, you know, how different types of changes in society changes the teams, the dynamics, the leaders, the resources. So I think, I think, and and also I had the opportunity to see in different countries serving as the Pan American trauma society president and all the all that I did before. I, I serve in that capacity for that society, teaching people in every like, places of Latin America with less resources and how, emotional regulations and how we show up for our team changes culturally, but also changes in the level of stress that you have. So meaning, you can have you're gonna have excellent if you if you put your mind to it, you can have excellent emotional regulation.

When you sleep eight hours a night, when you take a break for lunch, when you, don't have three emergencies to go to. But that changes when you understand that any mistake that you make can result in somebody's death and when you have three patients waiting for you and we have when you have work for forty eight hours straight without a break. Right? And, so and and and you have an Ethan also. Right?

So this is these are things that I think in health care, sometimes we take for granted, especially during residency. We have the eighty hour work, week rule, to avoid some people to work more than eighty hours. But what else do we have in terms of extending compassion to your team members? What all health care professionals, all health care professionals, we all have a deep compassion for patients. And we and that's our why, and that's why we show up, and that's why we train for longer, years than anybody else.

But can we extend that compassion to yourself and to your team members instead of going to judgment, to apply some curiosity? And it's interesting because I think health care is one of the places where we have where where the the concept that, you know, Brene Brown, talks about it very in a very eloquent way. The concept of being vulnerable and showing that it's brave, and showing up vulnerable allows your team members to also, be vulnerable and not, be super big and bad so so you cannot talk about the the the things that you need to talk about to improve, the care of our patients. So I think how does that result when, I I I can speak about our division. I think when I showed up, at the beginning in our division, there was some, culture transformation that needed to happen, same with the operating rooms.

But once you do that and once the team trusted each other, you know, they our our, discharges got faster. Our consult times were faster. Now we're like, our our relationship with the emergency medicine service, with EMS and paramedics, our our relation with them is better. So therefore, now, we are the trauma center that gets the most EMS, transfers referrals or patients in the entire state. With the operating rooms, we changed the way that we communicate with nursing and anesthesia and surgery.

We created a culture of trust, And that ended up, improving our metrics, improving our first on time start from what we have until what we have now. So I think that even though it sounds it sounds for people that are very scientific, that wanna always look at, the numbers or people that are still hooked up in hierarchies or, you know, impact factors, publications, and RBUs. It it's interesting how all goes back to this very, kumbaya in in in, you know, concept of compassion towards yourself, compassion towards your team members, having a culture of trust. And even though this seems like super soft, that level of empathy always results or at least in my experience and and, you know, I I might prove myself wrong later on in my career. But to now my in that in my experience, it will, improve your metrics.

It will improve the data. You have to invest in people. And, honestly, we're leading people. We're not leading, numbers. We're not leading a metric.

We're not leading a title. Right? So I think that is when you, I I I a 100% believe that through empathy and to vulnerability, we can create teams that where the trust is there and we can and that trickles down to better patient care, better quality metrics, better, you know, less less safety issues because people are not afraid to raise your hand and speak up.

Speaker 0: And that makes a lot of sense. And I I really appreciate the explanation there because, you know, it it can be, very critical in the clinical care space to keep these principles in mind, but easy, I I think, to forget them, especially, as you mentioned, when you're in a high stress environment or haven't necessarily been able to take care of yourself as a clinician and leader the way you'd like to. So, that makes a lot of sense. And I'm curious. What do you, typically do, I guess, or or what are you excited about when you look into the future of medicine and and see the leaders upcoming the pipeline within your organization and and beyond?

What do you see as being just something that you're really excited about their energy and passion and and more when you think about where health care leadership is headed?

Speaker 1: I'm really excited to see clinicians in leadership roles. So I think but but, Ant, those clinicians need to understand that leadership is a skill. Right? Some people are born with different types of skills, but, ultimately, leadership is a skill that needs to be learned, practiced, and, almost, like, daily. Right?

Like, a lot of introspection, a lot of reading, a lot of understanding, time invested with your team. I mean, if you're leading a team of people, it's important that you know them by name and story, not just by what they do for you or for the organization. I think when clinicians, the people that are at the bedside, the people that understand where the resources need to be placed, the people that are that are, like, you know, walking the walk. Those are the people that are trained and empowered and allowed to be in leadership roles. The the organization moves differently.

There's I, I think that people feel less at risk. People feel more understood. There's less, issues begging for what you need because those people that are that have been clinicians or are still clinicians understand what the patients need. So it's less about the bottom line, but in more about serving people. And then, ultimately, yes, it will make it will make, systems profitable.

Of course, no money, no no mission. Correct? That being said, our business is, our business needs improving lives, saving lives, better outcomes. You know, when we fail in leadership and when we don't create those, open environments for people to collaborate, it's not it's those mistakes are, are very are are are very, costly because we're measuring our success in how we impact other people's lives.

Speaker 0: That's fantastic to hear, doctor Farada. Thank you so much for joining us on the podcast today. Before we wrap up, is there anything else you would like to to leave our audience with, especially emerging leaders as they're, trying to navigate, the health care system right now and and figure out what it will take in order to be a great leader in the future?

Speaker 1: Yes. I I have several things to to to that I think are important. I think for, for those that are listening that wanna be in leadership, start training, start looking for, avenues to grow. And but more importantly, understand that leadership is not really about personal power, but it's about service. And if if serving is beneath you, then leadership is not for you.

However, I also wanna empower every clinician to understand that your leadership and your influence goes above and beyond a title of professor, associate professor, or chair, or, whatever the title might be because everybody around you are listening. The medical students are listening. The families are listening. Nursing is listening. Your partners in emergency medicine and and and other, specialties are listening.

And, and, ultimately, our why, the reason why we show up every day to the jobs that we show up for every day is to help people, to heal people. And so in order for us to do that, we have to be whole ourselves. If if there's some issue with emotional regulation or you feel stuck in, how you communicate, maybe it's important that you take a look inward, Do some introspection and lead yourself, understanding why are you you're not showing up the way that you need to show up. And once you heal inside and you find an environment where you where you feel that you can belong, where you're heard, when you're understood, where you believe, treasure that environment. And and and once you're there, help others too.

Lend a hand. That that's that's not only good for you and good for the other person, but, you know, all that secretion of oxytocin, serotonin, and dopamine when you're helping people prolongs your life as well. Ultimately, it's all of our jobs, everybody in health care, to, make this place a better place. And I'm not only talking about Innova. I'm talking about globally.

How do we leave something behind? How do we leave a legacy of trust and compassion so we can help others also grow?

Speaker 0: I love that. A legacy of trust and compassion is truly remarkable. Doctor Farada, thank you so much for joining us on the podcast today. This has been a really fun and informative conversation, and I look forward to connecting with you again soon.

Speaker 1: Thank you, Laura.