Latest / Becker’s Healthcare Podcast / Penny Jefferson, RN, Director of Clinical Documentation Integrity Services in the HIM Division of Patient Financial Services at UC Davis Medical Center

Transcript

Penny Jefferson, RN, Director of Clinical Documentation Integrity Services in the HIM Division of Patient Financial Services at UC Davis Medical Center · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
• 0:04
  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
• 0:11
  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where do they go
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  - to pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
• 0:45
  - visit beckershospitalreview.com
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  - and click on the events tab in the
• 0:49
  - upper right.
• 0:51
  - This is Laura Dierdo with the Becker's Healthcare
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  - podcast. I'm thrilled today to be joined by
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  - Penny Jefferson, director of clinical documentation
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  - integrity services
• 1:00
  - in the HIM division of patient financial services
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  - at UC Davis Medical Center. Penny, it's a
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  - pleasure to have you on the podcast today.
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  - Thank you, and I'm looking forward to the
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  - discussion.
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  - Absolutely. As am I. I know revenue cycle
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  - is such a interesting
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  - field and and a lot happening, lots of
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  - changes, and and I know everything that you
• 1:18
  - that you do at UC Davis is, you
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  - know, cutting edge and definitely in front of
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  - where the health care industry is headed. So
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  - I'm excited for our conversation here today. But
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  - before we dig in, can you tell us
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  - a little bit more about yourself and your
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  - background?
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  - Well, sure. Let's see. I've been
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  - a, in CDI for
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  - about the last thirteen years. I started out
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  - as a regular reviewer and have worked my
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  - way up through,
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  - the lead... Up through the leadership chain from
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  - lead to supervisor to now the director of
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  - CDI.
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  - Prior to that, I was an ICU nurse,
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  - you know, any kind of ICU nurse you
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  - could imagine,
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  - for the first fifteen years of my career.
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  - So I... It's easy for me to marry
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  - that clinical perspective with the with the revenue
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  - cycle and the coding side. I can see
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  - that patient in the bed in my mind,
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  - so, it helps me with telling the story.
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  - That's great to hear. And, you know, definitely,
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  - fantastic experience. It's so important to bring into,
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  - the revenue cycle side in that clinical space
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  - too. So could you give us a quick
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  - state of the union? What's going well this
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  - year, and what are you focused on for
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  - the rest of 2026?
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  - Oh, wow. Yes. That's a big question. But,
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  - the way I look at health care as
• 2:32
  - as a whole is I see the industry
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  - trying to protect the access and the quality
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  - while managing the rising cost of delivering health
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  - care.
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  - Our,
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  - CDI staff and a lot of our staff
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  - within UC Davis are becoming... Are being accreted
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  - by the union.
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  - And
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  - so those those labor costs are skyrocketing, so
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  - we have to deal with all that. So
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  - the higher cost of the workflow... Workforce,
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  - medication,
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  - supplies, infrastructure. I mean, if we just look
• 3:00
  - at the price of gas right now, we
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  - can... We know that any of our supplies
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  - are gonna cost more. But, also at the
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  - same time, physicians and staff
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  - are... They're navigating more administrative,
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  - requirements than ever before. You know, they were
• 3:13
  - never taught the business side of health care,
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  - and now we have all of these new
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  - requirements of them to document a certain way,
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  - say things in a certain way. And,
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  - so that's an added,
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  - challenge for them. But like I said before,
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  - my critical care background helps me
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  - in how I think about all of that.
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  - I, you know, I can talk the financial
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  - side. I can talk the staffing, operational efficiency.
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  - But,
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  - ultimately, those decisions affect whether a patient gets
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  - the the right care when they need it
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  - and whether the people providing that care can,
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  - they can support that
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  - in in the day... The time and the
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  - day that they have.
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  - I know we hear a lot of... About
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  - pajama time and things like that where physicians
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  - are having to do all of their documentation
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  - after they actually finish seeing the patients. And,
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  - hopefully, those are some of the things that
• 4:03
  - we can get worked out in the near
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  - future.
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  - But I don't think we can describe the
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  - industry's performance with one broad statement that everything
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  - is improving or everything is getting worse.
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  - Different... You know, every organization has different resources
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  - and serve different communities.
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  - So for me, the question is is whether
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  - are we building processes
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  - that that can make
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  - the care that we provide easier to deliver,
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  - and is it sustainable?
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  - What encourages me this year is the growing
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  - use of AI. I think there's
• 4:35
  - a very much a a time and a
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  - place for its use. The... My biggest concern
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  - is the security of the AI and
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  - the,
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  - future of the dependence
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  - on it and not losing our ability to
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  - critically think.
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  - The AMA's latest physician survey does show, increasing
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  - adoption and optimism
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  - about that potential
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  - to help with some of those repetitive,
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  - workflows.
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  - I I really do feel like that's progress,
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  - but adoption isn't... It's... Alone, it's not the...
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  - That final outcome. I wanna know whether a
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  - tool actively gives time back.
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  - It... Does it improve accuracy? Does it help
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  - a patient move through care with fewer delays?
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  - Those types of things are are always top
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  - of mind.
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  - And then I'm also encouraged by the opportunity
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  - to bring clinical and operational teams into the
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  - same conversation.
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  - We gotta break down those silos.
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  - A patient experience is one journey, but we
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  - as the industry,
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  - we need to understand what happens across that
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  - journey even when the work spans several different
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  - departments. So,
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  - you know, in the end, I wanna measure
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  - success in ways that matter to patients, staff,
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  - and the organization.
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  - My question is, are we making care more
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  - accessible? Are we reducing unnecessary work, and are
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  - we giving our teams the support that they
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  - need?
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  - I love that. And I think, you know,
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  - truly having that nimble team and encouraging to
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  - your point using AI, I know technology is
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  - changing quickly, and that changes everything else about
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  - what's happening operationally, staffing,
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  - and and really truly
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  - rethinking the processes
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  - in in operations. But from your point, as
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  - well, I think it it takes, such important
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  - preparation and being able to,
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  - transform the organization alongside the team. So from
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  - your perspective,
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  - how do you do that? How do you
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  - keep the folks you're working with focused on
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  - the right things and really get the results
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  - that you need while there's lots of changing
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  - happen... Happening around you?
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  - Oh, let's see. Some of the the biggest
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  - things is transparency
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  - with...
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  - So I want the team to know what
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  - we're doing and why.
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  - I want them to to understand our ultimate
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  - goal. I don't wanna collect data just for
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  - the sake of collecting data. I don't wanna
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  - do a process just because somebody decided it
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  - would be a good process
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  - to do. I wanna be able
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  - to have that
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  - return on investment of whatever it may be
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  - that we're implementing, changing, moving forward with. I
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  - want that to be able to be measured,
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  - and I want it to, you know, just
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  - like I was saying it in... When you...
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  - The previous question that you asked me, I
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  - want I want that to be measurable. I
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  - want to actually impact change within the institution.
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  - Does it help the workflows? Does it help,
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  - you know, give back time to our providers?
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  - Does it actually make things easier, or
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  - are we are we actually adding
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  - to,
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  - to the problem by creating more meetings, creating
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  - more work, creating more, you know...
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  - One of the funny things that I always
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  - think about is we're gonna have a meeting
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  - about a meeting to discuss the meeting that
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  - we had
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  - on a meeting yesterday.
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  - Things like that that just don't make any
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  - sense. And,
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  - I know there's a lot of memes out
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  - there that talk about all of that
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  - where you know, I really want everything that
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  - we're doing in in the industry and at
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  - our facility to have a purpose
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  - and be
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  - forward thinking enough to have the... An actual
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  - impact to what we're doing, whether that be
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  - in utilization review, whether it be for the
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  - physicians,
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  - you know, the documentation side of things. And,
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  - you know, one of the things that I'm
• 8:16
  - beginning...
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  - Starting to get very heavily involved in is
• 8:19
  - the denials and, you know,
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  - the... Making sure that we're moving things hopefully
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  - upstream to hope we prevent those denials
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  - and, you know, just making an ultimate impact.
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  - So I think when I start talking to
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  - different different groups about making these changes, I
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  - I always wanna start with those questions.
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  - And, you know, at the end, we may
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  - not have all of those questions answered, but
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  - we at least go into it with with
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  - the right intention and
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  - with the the team having the knowledge of
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  - what and the why behind it. I think
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  - transparency
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  - is key
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  - from leadership perspective,
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  - from, you know, from every level to,
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  - involving people that are doing any any work
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  - in your project
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  - to have them know what's going on, you
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  - know, how this is gonna look, who is
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  - gonna impact, things like that.
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  - I love that. I think,
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  - a leader that has that transparency can really
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  - be a difference maker. Now I know there's
• 9:16
  - a a lot happening in the industry as
• 9:18
  - we've discussed. So what are some of the
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  - big headwinds that you're keeping an eye on
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  - and preparing for?
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  - Oh, let's see.
• 9:26
  - One of the biggest challenges is the pressure
• 9:28
  - on our capacity. We have, you know, those
• 9:30
  - daily meetings on, you know, throughput and ER
• 9:33
  - capacity, you know, our financial capacity, workforce capacity,
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  - and, you know, the the time capacity. So
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  - when... You know, I didn't, you know, talk
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  - to a little bit in the first, question,
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  - when costs rise, organizations have to make difficult
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  - choices. So
• 9:50
  - my concern is that when we respond by
• 9:52
  - asking the same people to absorb more work
• 9:54
  - without first examining whether the process itself needs
• 9:57
  - changed,
• 9:58
  - a team can be busy all day long
• 10:00
  - and still spend too much of that day
• 10:02
  - correcting something that could have been handled earlier.
• 10:04
  - That's where, you know, I bring my focus
• 10:07
  - to where we wanna do prevention instead of
• 10:09
  - reaction.
• 10:10
  - So prior authorization and denials are a good
• 10:12
  - example.
• 10:14
  - The AMA continues to report that substantial concern
• 10:17
  - about the administrative burden for prior authorization.
• 10:20
  - So, say, you know, a patient, that process
• 10:23
  - that process can mean waiting for an answer.
• 10:25
  - For staff, it can mean repeated calls, additional
• 10:28
  - submissions, time spent locating information.
• 10:31
  - And, you know, I know there's tools out
• 10:32
  - there that can really help us with that
• 10:35
  - and do that
• 10:37
  - that process for us. I think that would
• 10:38
  - be a big win. But,
• 10:41
  - we need to understand why that... Why the...
• 10:43
  - Is that work occurring. Was the required information
• 10:45
  - missing? Was it present but not included in
• 10:48
  - in in the submission? Are we getting the
• 10:49
  - right codes requested?
• 10:51
  - Do we have a big enough code span
• 10:54
  - for for what we're requesting for... To be
• 10:56
  - approved for the patient?
• 10:58
  - Also, is there any disagreement about the clinical
• 11:00
  - evidence or the payer requirements? Those are those
• 11:02
  - are all different problems, and they all need
• 11:05
  - different solutions. But
• 11:06
  - if we, you know, go to the root
• 11:08
  - cause, that's where we stand to win.
• 11:10
  - So I want us to prepare
• 11:12
  - and use what we learn from individual cases
• 11:15
  - to improve the process,
• 11:17
  - you know, in totality, you know, bring financial
• 11:19
  - clearance, utilization review,
• 11:20
  - the physician advisor, CDI, coding, and appeals altogether
• 11:24
  - at the same table
• 11:25
  - and to really understand those reoccurring issues, where
• 11:28
  - are pain points, and,
• 11:30
  - decides who owns each step. And we'll know,
• 11:34
  - at the end, we'll know if the change
• 11:36
  - would help if we start plugging some of
• 11:37
  - those gaps.
• 11:38
  - One thing... One other thing is the
• 11:41
  - the speed of technology adoption. You know, I'm
• 11:44
  - really excited about AI, but I don't want
• 11:46
  - us to confuse purchasing a tool with improving
• 11:48
  - a workflow. We always, you know, need to
• 11:51
  - have that,
• 11:54
  - that thought process in mind that we need
• 11:55
  - to evaluate
• 11:57
  - its improvement. What is it going to improve,
• 11:58
  - and is it gonna have an impact? How
• 12:01
  - is information
• 12:02
  - validated? How errors are are gonna be identified?
• 12:04
  - Who is accountable for acting
• 12:06
  - on the output of the tool?
• 12:09
  - And privacy and security is one of probably
• 12:12
  - the most important parts
• 12:14
  - of, making a decision in the beginning
• 12:17
  - for any tool or anything that you're,
• 12:20
  - getting ready to adopt that talks about the
• 12:23
  - use of AI and data exchange.
• 12:27
  - A note can be beautifully written and still
• 12:29
  - failed to explain the clinical picture accurately.
• 12:32
  - A tool that saves time in one department
• 12:34
  - may create additional review work in another department,
• 12:37
  - and I've seen that over and over and
• 12:39
  - over.
• 12:40
  - So we need to break down those silos
• 12:42
  - and make sure everybody in that workflow is
• 12:44
  - aware of what's going on to,
• 12:47
  - to decrease those those challenges that we're having.
• 12:50
  - So my preparation starts with listening to the
• 12:52
  - team,
• 12:53
  - protecting their ability to think.
• 12:55
  - I don't have to be the smartest one
• 12:56
  - in the room.
• 12:58
  - Everybody in my... In every team has, you
• 13:00
  - know, great ideas, but... And know, their judgment
• 13:03
  - is is extremely valuable to me. I want
• 13:05
  - changes that help them use the different tools,
• 13:09
  - for anyone in the workflow with clear expectations
• 13:12
  - and enough support to make those changes work.
• 13:17
  - Got it. That makes a lot of sense
• 13:18
  - and and definitely,
• 13:20
  - you know, it means a lot when you
• 13:22
  - are thinking about all the different technology that's
• 13:25
  - coming in. I love the point you made
• 13:27
  - about not just a tool to increase the
• 13:29
  - speed, but really truly something that's going to,
• 13:32
  - be adopted and something that'll make a difference
• 13:34
  - for the overall team and the processes that
• 13:36
  - are in place. So,
• 13:38
  - I I think your point is very well
• 13:40
  - taken. Where do you see some of the
• 13:41
  - great opportunities for growth in the next two
• 13:43
  - to three years or so?
• 13:45
  - Oh, this is right up my alley.
• 13:48
  - One of the greatest opportunities I see is
• 13:51
  - to build a CDI model that, supports the
• 13:54
  - entire patient journey beginning before the patient enters
• 13:57
  - into the
• 13:58
  - hospital. You know, of course, CDI is very
• 13:59
  - near and dear to my heart, but I
• 14:01
  - see where
• 14:02
  - we sit at the we sit at the
• 14:04
  - center of,
• 14:06
  - the patient
• 14:09
  - the patient encounter.
• 14:11
  - We touch every part of it.
• 14:14
  - We're involved in almost every single part of
• 14:16
  - it, and I'm working right now to move
• 14:18
  - things up through even,
• 14:20
  - being at, admissions.
• 14:22
  - I want us to review the prior authorizations,
• 14:25
  - admission reviews, concurrent documentation,
• 14:27
  - as well as the post discharge follow ups.
• 14:31
  - I wanted, you know, CDI to be that
• 14:33
  - entire,
• 14:35
  - journey for the patient. I want them to
• 14:36
  - be involved because documentation
• 14:38
  - is part of every part of that patient's
• 14:40
  - journey. So CDI belongs in that space.
• 14:44
  - You know, CDIs are
• 14:47
  - are kind of where we sit. We are
• 14:49
  - a unique,
• 14:51
  - group of individuals that have that clinical expertise
• 14:54
  - that can marry the the coding concepts and
• 14:57
  - coding
• 14:58
  - language and get it translated into what needs
• 15:01
  - to go into the medical record to support
• 15:03
  - the accurate care that's given and,
• 15:06
  - the complexity of the patients.
• 15:08
  - We we help maintain compliance for the institution.
• 15:12
  - You know, we we ensure our risk adjustment,
• 15:16
  - factors are are accurately captured,
• 15:19
  - quality measures are accurately reported,
• 15:23
  - as well as,
• 15:24
  - the...
• 15:26
  - We want the the CDIs to be able
• 15:28
  - to give us good feedback,
• 15:30
  - in in all of those spaces so we
• 15:31
  - can identify, you know, what they're seeing as
• 15:34
  - opportunities
• 15:35
  - to,
• 15:36
  - improve the process.
• 15:38
  - So So if we see the same issue
• 15:39
  - repeatedly,
• 15:40
  - I want them to tell me, you know,
• 15:42
  - what they see and what they feel like
• 15:44
  - they can they can change.
• 15:47
  - We might need to start with, like, a
• 15:49
  - focus pilot.
• 15:51
  - We at at UC Davis are are working
• 15:53
  - towards this,
• 15:55
  - this happening. We don't have a pilot established
• 15:58
  - yet, but, you know, my vision is we
• 15:59
  - start with a pilot with CDI being part
• 16:02
  - of
• 16:03
  - the prior authorization
• 16:04
  - and at admissions, partnering with the utilization
• 16:08
  - review nurses,
• 16:10
  - and,
• 16:11
  - you know, ensuring that the inpatient medical necessity
• 16:14
  - documentation
• 16:15
  - is is in the medical record. With the
• 16:17
  - inpatient only list going away completely by 2028,
• 16:22
  - it's gonna be more important than ever. And,
• 16:24
  - you know, for our second level physician advisers,
• 16:26
  - we need to make sure that the conditions
• 16:28
  - of participation
• 16:30
  - are met when they're doing those,
• 16:32
  - those second level reviews for meeting,
• 16:35
  - the requirements for documentation for patients to,
• 16:39
  - to be in an inpatient,
• 16:40
  - bed in the hospital,
• 16:41
  - or is it appropriate for them to be
• 16:44
  - outpatient?
• 16:45
  - So those are the things that in that
• 16:47
  - space that I see as being very important
• 16:50
  - on on the front end. And then,
• 16:53
  - we want to be able to measure that.
• 16:54
  - That's one of the challenges as well. You
• 16:56
  - know, what is... How do you measure something
• 16:59
  - that you prevent? And, you know, hopefully, that's
• 17:01
  - gonna
• 17:03
  - be shown in prevention,
• 17:05
  - and decrease of medical necessity denials.
• 17:09
  - The DRG downgrades that we see,
• 17:12
  - I think those are those are a challenge
• 17:14
  - because
• 17:15
  - there are payers out there that
• 17:18
  - will
• 17:19
  - deny or not wanna pay at a certain
• 17:22
  - level
• 17:22
  - just to try and not pay.
• 17:26
  - But,
• 17:27
  - I think having CDI involved in in that
• 17:29
  - space is is absolutely
• 17:31
  - essential
• 17:32
  - so that the
• 17:35
  - the collaboration between coding and clinical can can
• 17:38
  - happen there and defend that DRG if it's
• 17:41
  - appropriate and and get that work done and
• 17:43
  - then help with the denials all the way
• 17:45
  - to the back end. So front to back
• 17:47
  - end is where I see the, you know,
• 17:49
  - the most impactful,
• 17:52
  - industry advancement for the next three years.
• 17:55
  - It'll... It takes a very
• 17:57
  - skilled group of people to be able to
• 17:59
  - do this, so I think there's gonna be
• 18:01
  - some some advanced education that's required.
• 18:04
  - Not everybody will be able to do this
• 18:06
  - job. Some, you know, CDI professionals will,
• 18:10
  - remain doing their regular
• 18:12
  - work from,
• 18:15
  - you know, doing those concurrent reviews. But we
• 18:17
  - are gonna need those special individuals that are
• 18:20
  - are capable of the
• 18:22
  - entire workflow from beginning to end. So there's
• 18:25
  - a significant opportunity for us in that space,
• 18:28
  - and,
• 18:29
  - I'd love to see CDI routinely included when
• 18:31
  - organizations
• 18:33
  - design these workflows. We have clinical expertise,
• 18:36
  - that can help at several points in that
• 18:38
  - patient journey, and I want us to be
• 18:40
  - intentional about where we use it.
• 18:43
  - I love it. I think that makes a
• 18:45
  - lot of sense. And, you know, certainly, I'm
• 18:46
  - thinking about all the complexity that goes in
• 18:48
  - the revenue cycle, but how important it is
• 18:50
  - for that financial sustainability of the whole organization
• 18:53
  - for it to be running well and and
• 18:55
  - certainly
• 18:56
  - decreasing those denials and figuring out how you're
• 18:59
  - getting... Optimizing the payments that you're contracted for.
• 19:01
  - And so, I think that makes a lot
• 19:03
  - of sense in,
• 19:05
  - making sure that you've got a team in
• 19:07
  - place that, you know, is continuously learning and
• 19:09
  - growing. It's no easy task, but it seems
• 19:11
  - like you've got, kind of a great culture
• 19:14
  - there that really can make a difference.
• 19:16
  - Yep. I'm proud of our culture here. Very
• 19:19
  - proud of it.
• 19:20
  - Absolutely. And, you know, when you think about
• 19:22
  - leadership,
• 19:23
  - who is a leader that you admire really
• 19:25
  - from any industry and why?
• 19:28
  - Oh, I have,
• 19:30
  - my... The leader that I admire most is,
• 19:32
  - Tammy Gomez. She,
• 19:34
  - and I know she's done a podcast for
• 19:36
  - you and Becker's as well.
• 19:39
  - She
• 19:42
  - she's just... She exemplifies what leadership should look
• 19:45
  - like. I've had a lot of leaders in
• 19:47
  - my career, and I've learned something from all
• 19:49
  - of them, good and bad.
• 19:52
  - I have worked with other amazing leaders.
• 19:54
  - I had an amazing leader,
• 19:56
  - Sally Hart at Mayo Clinic in Rochester. She
• 19:59
  - was amazing, and,
• 20:01
  - she really encouraged me to grow and expand
• 20:04
  - my,
• 20:05
  - my footprint in the industry. So I've had
• 20:07
  - two great recent leaders
• 20:10
  - to to help me move into where I
• 20:12
  - wanna be.
• 20:14
  - And as well as I can learn... You
• 20:15
  - can learn from the the type of leadership
• 20:17
  - that you don't want to to,
• 20:20
  - carry forward, you know, the things that, you
• 20:22
  - know,
• 20:23
  - made you either wanna leave a job or
• 20:26
  - leave an institution
• 20:27
  - or made you regret or not want to
• 20:30
  - come to work every day. So those are
• 20:33
  - learning opportunities as well. But the leaders I
• 20:35
  - admire most are servant leaders. They're the ones
• 20:38
  - that understand that part of that part of
• 20:40
  - their responsibility
• 20:41
  - is to grow the people around them.
• 20:44
  - They take the time to understand someone's strength,
• 20:47
  - strengths that they bring, ask where they they
• 20:49
  - want to go and help get them there.
• 20:52
  - So I really consider my success as a
• 20:54
  - leader to be reflected in the people I
• 20:57
  - lead and their success.
• 20:58
  - When someone grows in confidence and develops their
• 21:01
  - expertise or takes on an opportunity
• 21:04
  - they once
• 21:05
  - thought was out of their reach, that means
• 21:07
  - that means a lot to me. That makes
• 21:09
  - me feel successful.
• 21:11
  - You know? No award, no,
• 21:14
  - no piece of paper, no,
• 21:17
  - you know, accolades
• 21:18
  - for... You know, come from that, but it's
• 21:20
  - it's an internal,
• 21:23
  - point of pride for me to see other
• 21:25
  - people succeed around me and knowing that I
• 21:27
  - was... You know, helped contribute to it.
• 21:31
  - And I wanna know that my leadership helped
• 21:33
  - create the conditions for them to to be
• 21:36
  - successful in what they wanted to do.
• 21:38
  - You know, I don't need to be the
• 21:39
  - smartest person in the room. I want people
• 21:41
  - on my team to know more than I
• 21:42
  - do about their areas of expertise and I
• 21:45
  - think that's really, really important to recognize.
• 21:48
  - I want them to have the confidence and
• 21:50
  - the opportunity to use that knowledge. I want
• 21:52
  - them
• 21:53
  - to be the person others turn to, and
• 21:56
  - and I want their contributions to be recognized
• 21:59
  - as well. So supporting someone's ideas,
• 22:02
  - meaning giving those ideas real consideration. If someone
• 22:05
  - sees a better way to do something,
• 22:08
  - I wanna hear it. We may need to
• 22:09
  - work through the resources, the risks,
• 22:12
  - how we would,
• 22:13
  - measure that success, but I want them involved
• 22:16
  - in developing the solution and presenting it. They
• 22:18
  - should get,
• 22:19
  - and they should get that recognition for their
• 22:22
  - work. And, you know, I've
• 22:24
  - talked about it earlier, but trust is a
• 22:25
  - big part of that and transparency.
• 22:28
  - You have to give people room to make
• 22:29
  - decisions and take ownership of those. So if
• 22:32
  - every decision has to come back through me,
• 22:34
  - I need to ask whether I'm... Whether I've
• 22:36
  - given them the clarity and authority that they
• 22:38
  - need to move forward with that. And sometimes
• 22:40
  - it's difficult as a leader to do that.
• 22:43
  - You know, that's some of the,
• 22:45
  - the... My learning curve with, you know, moving
• 22:47
  - up in leadership is
• 22:49
  - is kind of cutting that umbilical cord of
• 22:52
  - me feeling like I have to be responsible
• 22:54
  - for everything. And so as you grow and
• 22:56
  - get higher in that...
• 22:59
  - In different levels, it's
• 23:01
  - it's that learning process that,
• 23:03
  - you trust the leaders that are,
• 23:06
  - the report to you. And
• 23:08
  - so I think that's a... An ever ever,
• 23:12
  - existing challenge for for everybody that's out there.
• 23:16
  - But
• 23:16
  - being successful at that is is part of
• 23:19
  - the success that,
• 23:21
  - that I want to have.
• 23:23
  - Some of the less positive leadership experiences
• 23:26
  - in my career have made me more conscious
• 23:28
  - of how I respond when someone disagrees with
• 23:30
  - me or brings me a problem.
• 23:33
  - My response affects whether they'll feel comfortable doing
• 23:36
  - it again.
• 23:37
  - That
• 23:38
  - has a lot of,
• 23:41
  - personal impacts for me, so that is one
• 23:43
  - I take very seriously.
• 23:45
  - I want people to always feel like they
• 23:47
  - can come to me, and that's one thing
• 23:48
  - that,
• 23:50
  - Tammy is
• 23:52
  - 100%
• 23:53
  - open to is anytime we have an issue
• 23:55
  - or have something going on, I can take
• 23:58
  - it to her. And I learned from her,
• 24:01
  - her actions, how I want to lead in
• 24:03
  - that space.
• 24:06
  - I wanna... So I absolutely want concerns brought
• 24:09
  - forward while we still have an opportunity to
• 24:11
  - address them. And then I have to create
• 24:13
  - an environment where that can happen, where the
• 24:15
  - people feel comfortable.
• 24:19
  - That matters with the vision I have for
• 24:21
  - our CDI team and for anybody else that's
• 24:24
  - working around or with me.
• 24:27
  - You know, absolutely, by moving our expertise earlier
• 24:29
  - in the patient journey, we'll take contributions from
• 24:31
  - people who understand different parts of the process.
• 24:34
  - I can bring the vision, but I I
• 24:36
  - absolutely need to listen
• 24:38
  - to all of those other people who are
• 24:40
  - part of different departments to help make it
• 24:42
  - all work.
• 24:44
  - So I I wouldn't attribute my leadership style
• 24:46
  - to just one person. It has been shaped
• 24:49
  - by many people and experiences.
• 24:52
  - The qualities I try to carry forward are
• 24:54
  - trust, accountability, and willingness to listen,
• 24:58
  - and a commitment to helping people grow even
• 25:00
  - when their next opportunity to takes them. That...
• 25:02
  - It may take them beyond my team. They
• 25:04
  - may, you know, see an opportunity,
• 25:06
  - you know, outside of what we have at
• 25:08
  - UC Davis
• 25:09
  - Davis available. So when I look at the
• 25:10
  - people I've led and see what they're accomplishing,
• 25:13
  - that's, you know, that's where I see my
• 25:15
  - success as a leader, and that's what I've
• 25:17
  - learned from my, the people I admire most
• 25:20
  - as leaders.
• 25:23
  - I love it. Penny, thank you so much
• 25:25
  - for joining us on the podcast today. This
• 25:26
  - has been a really fun conversation.
• 25:29
  - Just learned a ton, and it was really
• 25:30
  - cool to hear from you. Thank you so
• 25:32
  - much for your time. I look forward to
• 25:33
  - connecting with you again soon.
• 25:36
  - Thank you very much. I've enjoyed the the
• 25:38
  - conversation as well, and I hope you have
• 25:40
  - a wonderful afternoon.