Latest / Becker's Healthcare Behavioral Health / Dorinda Mueller, CEO of Aliso Ridge Behavioral Health

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Dorinda Mueller, CEO of Aliso Ridge Behavioral Health · Becker's Healthcare Behavioral Health

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This is Riley Wilson with the Becker's Behavioral
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Health podcast. I'm thrilled to be joined today
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by Dorinda Mueller. Dorinda is the CEO
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of Aliso Ridge Behavioral Health.
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Thank you so much for joining us today.
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Before we get started, could you please introduce
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yourself and tell us a little bit more
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about your background?
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Sure. Thank you, Riley.
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I'm currently serving as the chief executive officer,
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like Riley said, for a for profit acute
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psychiatric hospital in beautiful Southern California.
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I've been here for two years following my
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tenure as chief operating officer. I've also been
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in the role of chief nursing officer.
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I am a nurse by background. I've been
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a registered nurse for over twenty five years
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now.
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I've worked in administration for over eighteen years,
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spanning large trauma hospitals in Downtown Los Angeles
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to smaller general acute care hospitals throughout Southern
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California.
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My nursing career started actually in obstetrics,
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labor, and delivery over twenty three years ago,
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leading me to obtaining my nurse practitioner credential
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in women's health.
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I worked as a women's health nurse practitioner
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in many outpatient settings,
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but that ultimately landed me in infertility and
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pregnancy psychosis
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or my pathway now to mental illness.
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I did continue my education with a master's
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in women's health and then later a second
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master's in education and research.
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My training in women's health really fundamentally
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set me up for my passion in mental
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health.
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I the pandemic
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has always
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fed my curiosity
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for my personal mission and philosophy to continue
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work within the mental health arena,
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and my clinical foundation as a nurse practitioner
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continues to inform my leadership approach,
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grounding strategies,
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and even my patient centered care and operational
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avenues for treating patients and making sure we're
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meeting needs of the clients in the community.
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K. Well, thank you again for joining us.
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My first question for you is is a
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two parter. You know, what are the biggest
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opportunities do you have your eye on right
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now, and then what's the biggest headwind that
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you're watching?
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Oh, great question. I'd say biggest opportunity by
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far is AI.
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Honestly, digital therapies.
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We've already began piloting AI behavioral health tools
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here in an acute psychiatric
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setting.
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We've found it to be beneficial, but we're
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still working through some of the challenges. So
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that opportunity has led us to a headwind,
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believe it or not. We're trying to expand
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access to care,
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and
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also supporting our novice clinicians
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who are entering the workforce,
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with limited experience working with difficult
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behavioral health backgrounds.
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Maybe patients that minimize,
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patients that have difficulty,
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initially upon arrival expressing some of the concerns
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or feelings they've been experiencing.
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So the AI tools really support in a
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different format of reading some behavioral cues
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and speech,
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and applying different assessment scores for the patients.
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It's helped to detect early signs of distress,
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really uses the patient's speech, other behavioral
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analysts,
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Also, personalized treatment,
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advancing
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of the space in neuroscience
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has really helped us to tailor our innovations,
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whether we're looking at interventions that are outcome
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specific matching the patient with the most effective
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therapy or whether that be medication management.
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There's a lot that's out in mental health
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right now as opportunities. There's wearable devices that
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will track your mood in the form of
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a ring or a watch,
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let you know how well you slept last
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night, really empowering the user to
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strive for the best mental health outcomes they
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can.
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There's virtual
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technology
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out there that's supporting
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PTSD,
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anxiety, even phobias,
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entering a patient into a VR
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realm of a phobia they experience without having
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to actually
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immerse them into the situation
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has been
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proven to be very effective and in a
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great environment for healing. And then there's also
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your just your workplace initiatives,
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employers as us investing
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in the demand,
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investing in the treatment or the care that
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our frontline staff require.
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So supporting that employee well-being,
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which ultimately drives patient satisfaction.
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I'd say headwinds,
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mostly access to care,
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even being in a very affluent area in
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Southern California,
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there is a huge
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gap between
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affluent society and the very vulnerable or, underserved
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population.
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Rural, low income communities
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where maybe their access to Internet isn't there.
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So the all these great all the best
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wearable mental health apps
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may be available to them, but without the
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right Internet speed or carrier, they're not even
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able to access that particular type of
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media,
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workforce
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shortages. So there's definitely a demand for licensed
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mental health professionals
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that continues to grow,
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but it's an interesting
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it's an interesting environment to recruit for.
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We've found that
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clinicians directly out of school
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are somewhat
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timid,
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and maybe shy away from an inpatient psychiatric
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setting where the experience is very beneficial,
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but the understanding
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of the environment itself is not necessarily taught
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in school.
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So there's an a turnover that's associated with
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that. Or there's also the staff that's interested
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in receiving their
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hours they're experiencing and then joining on to
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do some
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distance,
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virtual
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work elsewhere. So, again, that just feeds more
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into the overturning
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the staff retention
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when you have novice staff coming in that
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are trained who want the experience only to
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leave and start their own sort of personal
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practice.
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It can be very draining on the existing
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staff.
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Digital overload, there's
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tech tools for healing. There's excessive screen time
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and social media use though in the youth
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that's
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just adding to raising anxiety and depression.
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And then I'd say there's privacy involved.
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These AI tools are advancing very quickly almost
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in front of our ability to understand what
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that impact could potentially mean,
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whether that be
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patients'
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data in these platforms being shareable to entities
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that have access to that information and how
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to make sure the patient's responses in that
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platform
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are protected, are safe, and aren't used
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any in any negative context in the future.
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So being able to give them
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that peace of mind so they are participative
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and supporting really what their privacy would look
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like.
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Yeah. Absolutely. I'm glad, you brought up AI
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as a big part of what you're watching.
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I've spoken with a lot of behavioral health
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leaders lately, kind of on different
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paths at different stages with AI, whether they're
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just starting to think about what it can
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mean for their organization now or whether they've
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been using it for a while. So it
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sounds like that this is something, you know,
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you've been using. So I'm curious to hear
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from you. You know? How has your staff
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responded to the AI tools you've implemented, and
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what have they found,
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most helpful about them?
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Yeah. Very interesting. I'd say the experience staff
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is somewhat offended by the AI tools.
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Initially, when we launched,
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it was to say, well, I can judge
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I can assess a patient's anxiety.
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I can assess their
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depression score myself.
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I don't need them to answer
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a five point quiz and do a bit
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of video recording to get that assessment score.
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I can tally it myself.
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But we we did find that it was
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very helpful for our more novice clinicians
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who weren't used to an asking questions in
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a manner that may elicit the same answers
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or responses.
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So it really supported
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their training. If a patient scores
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very high,
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risk on this AI tool and the clinician
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now in their own personal assessment
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with the patient side by side
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sees that there's a huge gap,
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in the data they're collecting or the responses
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they're collecting. It gives them the opportunity to
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heighten their awareness to particular pieces, whether it
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be a heightened awareness to psychosis
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or to depression,
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And especially with patients who are minimizing
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their symptoms for whatever reason,
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it could just be an intimidating environment and
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they're afraid of if what they say will
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result in a heavy medication dose or
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a response by
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a provider that,
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they wouldn't want. They may
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tailor their responses in the way they want
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the health care worker to hear it. So
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the AI tools have been great in really
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weeding through a lot of that
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particular information.
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And then we found that that our best
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approach is actually to partner with the assessment
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tool. So we're not taking away the expertise
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and the wherewithal of the clinicians at the
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bedside,
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but we're using it as another data point.
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So it's just to foster additional support of
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potential
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short term or long term goals that should
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be created in the response of the patient's
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responses.
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It's also helped us to trend their information
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from admission
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throughout the midpoint of their stay and then
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right before discharge.
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We found the providers, the physicians themselves, the
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psychiatrist
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will often if the results on discharge
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have demonstrated very little improvement,
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initially, their response was, well, I know that
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they have great linkages. I know they're gonna
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be compliant with their medication. I'm okay with
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still discharging them. But it still caused them
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to a moment of pause
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in allowing a patient to discharge who perhaps
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all of those things hadn't been done. And
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instead, they were asking questions that they might
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ordinarily assume are done. Assume that the patient
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already has their aftercare appointment.
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But when they had this data in front
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of them, they were forced to say,
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let me check with the team and make
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sure there is an aftercare appointment.
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Let me dot my i's and cross my
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t's. So that's how we've sort of been
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able to integrate it in the system is
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we rolled it out very intentionally,
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and we ensured that
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everyone had a voice during the process
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of the rollout and that there weren't emotions
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or,
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any negative
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punitive nature to when a clinician score was
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different to what the
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AI generated
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technology score was.
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Great. Well, thank you so much for sharing.
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That's really fascinating, the different uses you're finding,
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for AI. I wanna
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shift topics here and hear from you. What
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do you see as one risk or one
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investment that's worth making this year?
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That's a great question. I think in California
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itself, there's a huge shift towards outpatient treatment.
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It's a strategy that's trying to meet the
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demand, reducing
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emergency room impaction,
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aligning with state and federal
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goals.
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And the outpatient setting is a great opportunity
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for being able to meet those needs, and
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so I think that's the best investment
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at the time.
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Risk, interestingly enough, is probably workforce shortages.
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There's a hard
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it's it's hard to know what's actually going
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to work.
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The culture of the employ those seeking employment
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evolves so quickly,
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and so it does become more challenging when
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you think,
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okay. Facebook advertising
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is working this week, but next week, there's
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a new platform.
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And so when you're in when you're actually
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demonstrating
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revenue
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or attempting to apply a profit margin to
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something that is a guess,
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it's really risky. And you don't know what
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your
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return on that investment is going to be.
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If you do a Facebook
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ad and you only have one employee
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potentially
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apply to a position,
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is that really effective at that point? And
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when the employee applies to
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the great
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advertisement that you've posted,
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are they really interested in doing the work
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and living the purpose or the mission of
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your organization? That's hard to determine. So there's
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lots of risks, I believe, that we take
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in these workforce shortages with retention bonuses
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and advertising,
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onboarding,
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job events, job fairs.
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And it's very it's it's because that market
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changes so quickly,
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that it's really honestly, it's the
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new hire has all of
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the all of the opportunity to have all
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the choices,
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and you're competing. The comp the market is
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just so competitive for us as an employer
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to find quality applicants, I'm afraid.
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Yeah. No. That's a challenge for so many
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behavioral health providers right now is navigating those
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workforce challenges. So thank you so much for
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sharing how you think about risk and opportunity
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in that space.
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My last question for you today, where's your
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best opportunity for growth in the future?
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I think our best opportunity honestly is around
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youth services,
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adolescent population in particular.
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It the mental health crisis continues to escalate
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in that population,
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and hospitals that invest in
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tailored
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programs, intentional inpatient programs
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that include family engagement,
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school reintegration,
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planning for the needs of the child for
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post discharge,
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those are honestly going to be, the huge
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opportunities for growth. And that can even lead
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towards additional outpatient
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programming.
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Again, here in California,
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there is a commitment with even the federal
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and the state level
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for budgetary dollars that are feeding into outpatient
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programs.
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So identifying
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those youth spaces
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and being able to meet the needs of
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the community are huge
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for opportunities for growth growth. And then I
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think work workforce innovation is another opportunity
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because if if you can get in front
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of recruitment of
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pay of appropriate
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staff for based on the national shortages
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and
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implementing clinical ladders or peer support roles
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or opportunities for cross training, you're going to
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have
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invested staff that provide quality care to the
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pay to the patient that you're looking to
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serve. And then really looking for outcome driven
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goals,
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metrics that your staff can find tangible,
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metrics that you can actually brag and share
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with your payer sources,
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whether that be insurance companies
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or even
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county contracts within your facilities.
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Those are great opportunities for you to demonstrate
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the quality care you're providing
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and to really reinforce
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your growth for the future. Look how successful
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we've been in this outpatient program for youth
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patients.
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We are so successful, and our outcomes are
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so great that we're opening up an additional,
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additional track. And it helps then as well
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with those key stakeholders.
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They're buying and supporting those programs, and they'll
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begin to be your on the ground marketing
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and doing a lot of that
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face to face
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reputation
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branding for your facilities.
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Great. Well, I wanna thank you so much,
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Jorinda, for joining us today, and we hope
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to have you back again on the podcast
16:25
soon and hear more about,
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how these initiatives investments you're making continue to
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grow.
16:31
Awesome. Thank you so much, Riley.