Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Expanding Behavioral Health and Strengthening Pediatric Care at Dayton Children's with Ben Goodstein

Transcript

Expanding Behavioral Health and Strengthening Pediatric Care at Dayton Children's with Ben Goodstein · Becker’s Healthcare -- Pediatric Leadership Podcast

• 0:00
  Welcome to Becker's Healthcare Podcast. I'm Chris Sosa,
• 0:02
  your host. And I'm thrilled to be joined
• 0:03
  by Ben Goodstein. He is vice president and
• 0:05
  chief ambulatory officer of Dayton Children's Hospital
• 0:08
  and president of Dayton Children's Specialty Physicians. Ben,
• 0:11
  thank you for joining us today. Thanks, Chris.
• 0:13
  Great to see you. Yeah. Likewise. So glad
• 0:15
  to have you on. So for those in
• 0:17
  our audience who maybe are not too familiar
• 0:19
  with yourself and Dayton Children's, could you give
• 0:21
  us a little bit about both? Sure. We're
• 0:23
  about a 230 bed children's hospital, one of
• 0:26
  the six smallest in the country. We are
• 0:28
  on the most competitive market in the world
• 0:30
  when it comes to pediatrics. There are six
• 0:31
  other pediatric hospitals in the state of Ohio
• 0:34
  and two in Indianapolis that that are all
• 0:36
  part of our,
• 0:37
  our our region,
• 0:39
  for health care for kids.
• 0:41
  And it makes us a very,
• 0:43
  unique hospital amongst them as one of the
• 0:46
  only stand alone independent children's hospitals that's that
• 0:48
  small.
• 0:50
  Thank you, Ben. So
• 0:51
  before we get into 2026,
• 0:53
  let's look a little bit back at 2025.
• 0:57
  So looking at that year, what would you
• 0:58
  say is the most important initiative you led?
• 1:01
  Just give us a bit about, the results
• 1:02
  that happened and how the whole project evolved.
• 1:04
  It could be more than one, but, you
• 1:06
  know, let's start with one. So I I
• 1:08
  would I would start off with behavioral health.
• 1:10
  We're we're investing about a $180,000,000
• 1:12
  into behavioral health.
• 1:13
  In August 3 on August 13, we, opened
• 1:16
  up our new behavioral health hospital,
• 1:18
  which is a standalone 48 bed hospital
• 1:21
  with a 12 bed crisis center, a day
• 1:23
  treatment program,
• 1:24
  a bridge program, psychiatry, and psychology.
• 1:28
  So, basically, the entire
• 1:31
  behavioral health network is in that building, which
• 1:33
  is fantastic.
• 1:34
  At the same time, we started redistributing
• 1:37
  therapists
• 1:38
  throughout our region and beyond,
• 1:40
  specifically
• 1:41
  linking them up with our other nine 19
• 1:44
  or 20 offsites that we have so that
• 1:46
  the families could, access that that therapy
• 1:49
  outside of the main campus in in their
• 1:52
  communities.
• 1:53
  A huge opportunity for us to to engage
• 1:55
  the community.
• 1:56
  We got some state funding, about $25,000,000
• 1:59
  of the building was funded by the state.
• 2:02
  And then the Mateel family,
• 2:03
  the previous owners of Vimes Dog Food,
• 2:06
  gave us a $10,000,000
• 2:07
  grant, which was really beneficial.
• 2:10
  So the name of the building is the
• 2:11
  Mathieu Center for Health and Wellness,
• 2:14
  and and we couldn't do this without without
• 2:17
  donors like them.
• 2:18
  Since we opened in August, we expected a
• 2:21
  slow ramp up. We've been at 90% or
• 2:23
  95% capacity since the day we opened. That
• 2:26
  is primarily in our inpatient units.
• 2:29
  We're open to 30 beds at this point.
• 2:31
  We expect to open the other 18 beds
• 2:33
  in the next two months.
• 2:35
  The the need for this kind of care
• 2:38
  has definitely outpaced what expectations were.
• 2:41
  And really import more importantly,
• 2:44
  we're serving a a unique population of kids,
• 2:47
  and that strategy has really paid off for
• 2:49
  the community as a whole.
• 2:51
  Some of the benefits from that is the
• 2:53
  payer mix on the inpatient unit is, about
• 2:56
  a fifty fifty split, but we're able to
• 2:58
  be profitable on that unit, which helps us
• 3:00
  fund some of the other things we do
• 3:02
  in our behavioral health network.
• 3:04
  Some of those things include integrated primary care
• 3:06
  with behavioral health, where we have a psychologist
• 3:09
  and a psychiatrist go into a primary care
• 3:10
  practice,
• 3:11
  teach up some of the providers on how
• 3:13
  to manage low level issues with mental health,
• 3:16
  and then provide a therapist in their clinic
• 3:18
  two to three days a week to do
• 3:20
  local therapy, for any of those kids that
• 3:22
  we can manage in their clinic,
• 3:24
  to keep the kids away from the hospitals
• 3:27
  and hopefully out of the inpatient world. Our
• 3:29
  readmission rates in that behavioral health, 48 bed
• 3:33
  unit right now is less than twelve percent,
• 3:35
  which is really good for behavioral health, and
• 3:37
  a lot of that has to do with
• 3:39
  the advanced services and the relationships
• 3:41
  we have with other mental health community partners,
• 3:44
  along with our services. So when a kid
• 3:46
  leaves our unit, we warm hand off them
• 3:49
  to some type of therapist,
• 3:51
  psychologists, psychiatrists,
• 3:54
  LASW, or LPCC. So that would be the
• 3:56
  biggest thing we did last
• 3:57
  last year. That's certainly huge, Ben. Congratulations to
• 4:00
  you and the whole organization on putting all
• 4:02
  that together.
• 4:04
  Let me ask you, though. When you're
• 4:06
  launching such a enormously
• 4:08
  important
• 4:10
  project, what's something you've learned
• 4:13
  going through that whole process?
• 4:15
  Yeah. I I think the biggest thing we
• 4:17
  learned is when you move patients from one
• 4:20
  hospital
• 4:21
  in the same system to another hospital that's
• 4:23
  separate from the main building, there is a
• 4:26
  lot of challenges that we did not necessarily
• 4:29
  were apprised of. We even had a transition
• 4:31
  company that came in,
• 4:33
  Yellowbrick, to to help support us through that.
• 4:36
  But we put a crisis center over there,
• 4:38
  and that's a level b ED.
• 4:40
  And the number of transfers is one of
• 4:42
  the things we didn't expect.
• 4:44
  Some of these count kids come in with
• 4:46
  medical conditions as well as behavioral health conditions,
• 4:49
  and transferring back and forth between the hospital
• 4:52
  and this this unit
• 4:54
  was a big struggle. I think in the
• 4:55
  first forty five days, we had over 200
• 4:58
  transfers.
• 4:59
  So that was not something we expected.
• 5:01
  We've since figured that out, and did some
• 5:03
  more streamlining.
• 5:05
  A lot of this stems from when a
• 5:07
  patient's in our ED,
• 5:08
  we were discharging them and readmitting them over
• 5:11
  in this other location, and what we needed
• 5:14
  to do was a transfer. But it's just
• 5:16
  working through that that that process and understanding
• 5:18
  that we're never gonna be perfect at this.
• 5:21
  We're not supposed to be perfect at this,
• 5:23
  but we're learning and and and and moving
• 5:25
  forward positively from each one of these little
• 5:27
  hiccups that we've found.
• 5:29
  Yeah. Certainly. Constant improvement is is an admirable
• 5:32
  goal and probably the best one you can
• 5:33
  hope for in those sort of settings. But,
• 5:35
  yeah, I'm glad things are
• 5:36
  are improving on that end. Alright. Ben, let's
• 5:39
  take this opportunity now to look ahead. So
• 5:42
  what would you say are the biggest priorities
• 5:44
  and headwinds you're focused on for this year?
• 5:47
  A little bit into '26, but still a
• 5:48
  lot to go. And any tailwinds you might
• 5:50
  be, looking forward to having boost you.
• 5:54
  Yeah. So I would say a couple things.
• 5:55
  Some of the biggest priorities right now is
• 5:56
  workforce management,
• 5:58
  specifically around subspecialty
• 6:00
  providers
• 6:01
  and making sure that we have a strong
• 6:03
  mayor and power plan that supports,
• 6:06
  the recruitment and retention of those providers. I
• 6:08
  think the retention is the most important thing.
• 6:11
  For the last five years at Dayton Children's,
• 6:13
  our medical group, which is Dayton Children's specialty
• 6:16
  physicians,
• 6:18
  our our engagement rates ranged from 96.5
• 6:21
  to 98
• 6:22
  for the last six years, and we received
• 6:24
  the AMA Gold Award for engagement,
• 6:26
  for our providers in 2025.
• 6:28
  It's a very prestigious award. I think we're
• 6:30
  one of maybe a handful of pediatric hospitals
• 6:33
  that even received the award. We're the only
• 6:36
  one in the state of Ohio to receive
• 6:37
  it, And it's really kudos to the way
• 6:39
  that we have done our engagement with our
• 6:41
  providers,
• 6:42
  focusing on wellness,
• 6:44
  focusing on, what we call pajama time, making
• 6:47
  sure that we give them all the AI
• 6:49
  tools necessary for them to be wildly successful.
• 6:51
  So
• 6:53
  those are some of the big priorities we're
• 6:55
  gonna be focusing on. And then, obviously, some
• 6:57
  of the the staff
• 7:00
  positions are also gonna be really important. We're
• 7:02
  struggling with pharmacy techs, surgical techs,
• 7:05
  respiratory therapists, x-ray techs, ultrasound techs.
• 7:09
  So that that that category of,
• 7:12
  highly educated technologists are gonna be a big
• 7:14
  priority as we continue to focus moving forward.
• 7:17
  And, obviously, our nursing partners. Our nursing partners
• 7:20
  are gonna continue to be really difficult positions
• 7:22
  to fill,
• 7:23
  but we're excited that we have the engagement
• 7:25
  that we have. So Dayton Children's at Press
• 7:27
  County,
• 7:28
  we received a 4.78
• 7:30
  out of a five for leadership index, which
• 7:33
  is really, really strong.
• 7:34
  And I think that kind of culture and
• 7:36
  that kind of relationships really
• 7:38
  have moved us forward.
• 7:40
  I think some of the headwinds that we've
• 7:42
  been focused on is primary care alignment.
• 7:44
  Primary care has really helped drive
• 7:46
  a better clinical quality for the children in
• 7:49
  this region.
• 7:51
  Not necessarily everyone is owned, but we definitely
• 7:53
  have collaborating agreements for a majority of those
• 7:56
  pediatric practices.
• 7:57
  And that just helps align them with the
• 7:59
  the the subspecialists
• 8:01
  in the same organization and not having to,
• 8:05
  you know, fax a result for or this
• 8:06
  one and then send a referral via email
• 8:09
  for this one. It really just kinda streamlines
• 8:11
  how we run our operations,
• 8:13
  which benefits the kids significantly.
• 8:15
  The second part of that primary care is
• 8:17
  access to primary care and making sure that
• 8:19
  we have access to the subspecialists.
• 8:21
  So I think those two headwinds have really
• 8:23
  helped us focus on what we need to
• 8:25
  do for 2026.
• 8:26
  So to summarize that, I would say, we
• 8:28
  need to focus on recruitment and retention of
• 8:31
  the staff that we have, recruitment and retention
• 8:33
  of the providers,
• 8:35
  and leveraging our APPs to the best of
• 8:37
  our ability to support the subspecialists,
• 8:40
  and then lastly, making sure that we have
• 8:41
  good access,
• 8:43
  across our spectrum of care so that the
• 8:45
  families in Dayton stay in the Dayton region.
• 8:48
  Makes sense, Ben. It sounds like you have
• 8:50
  a really good foundation on which to build
• 8:52
  and and retain and engage that staff as
• 8:54
  difficult to task as that might be,
• 8:56
  not just for yourself, but other organizations.
• 9:00
  Along those lines, Ben, so what would you
• 9:02
  say is the hardest thing you have to
• 9:04
  do
• 9:05
  this coming year? Doesn't mean you're not looking
• 9:07
  forward to it, but it just means that
• 9:09
  you're gonna have to have a really special
• 9:11
  level of focus to accomplish it. Sure. It's
• 9:14
  budget.
• 9:15
  Okay.
• 9:16
  I think it's gonna be a challenge this
• 9:18
  year with budget across the across all organizations.
• 9:21
  There's a lot of things going on politically
• 9:23
  that could impact our budgets at a state
• 9:25
  level and a federal level. So I think
• 9:27
  that that's gonna be one of the hardest
• 9:28
  things we're gonna have to try to manage
• 9:30
  to the best of our ability
• 9:31
  in the coming year. Couple things that affect
• 9:34
  that is, you know, what's gonna happen at
• 9:35
  the federal level with three forty b and
• 9:37
  whether that's a successful program
• 9:39
  to stay in the in in the hospitals
• 9:41
  or whether that's gonna get parsed out to
• 9:43
  our state.
• 9:45
  And then some other options that that are
• 9:47
  gonna be a challenge for us is the
• 9:49
  the Medicaid and Medicare reimbursement rates and and
• 9:52
  where they stand.
• 9:53
  Some other things that are gonna be aligned
• 9:55
  with that is we only have x amount
• 9:56
  of dollars for capital. And at the rate
• 9:58
  that we're recruiting docs, we're running out of
• 10:00
  capital
• 10:01
  pretty fast pace. So I don't think that
• 10:04
  there are insurmountable things, but there are definitely
• 10:05
  gonna be challenges in the coming year.
• 10:08
  Understood. So finally, Ben,
• 10:11
  you mentioned some of the programs that you
• 10:12
  have going on where you've been able to
• 10:14
  expand and and access to care at Dayton
• 10:17
  Children's.
• 10:19
  From here on out, what do you see
• 10:20
  as the best opportunities for growth at in
• 10:22
  your organization? Could be the next
• 10:24
  six months, three years, five years, whatever timeline
• 10:27
  you feel is appropriate that you're looking forward
• 10:29
  right to right now. Yeah. So I I
• 10:31
  would say the biggest opportunities for growth is
• 10:33
  that we're gonna have a new c suite
• 10:35
  leader in the next year. So making sure
• 10:37
  that there's clear alignment with that new leader,
• 10:40
  making sure that our culture is protected,
• 10:43
  and that culture is about engagement and trust.
• 10:46
  And then focusing on our core,
• 10:49
  market competitive specialties,
• 10:52
  at the same time growing our primary care
• 10:54
  network, which is gonna be super important.
• 10:56
  And then the last part of that is
• 10:58
  our organizational growth and behavioral health, making sure
• 11:01
  that we're able to do that in a
• 11:03
  productive way that serves the community first,
• 11:06
  but also supports the organization's three to five
• 11:08
  year strategic financial plan.
• 11:11
  Thank you so much, Ben. It sounds like
• 11:12
  Dane Children's is set up for a really
• 11:14
  exciting
• 11:15
  year ahead, and hopefully, we'll be able to
• 11:17
  catch up with you on all this at
• 11:19
  a later date. But in the meantime, you
• 11:20
  know, we'll see you come April and, you
• 11:22
  know, hopefully, that won't be the last time
• 11:24
  our paths cross. Absolutely. I look forward to
• 11:26
  seeing you in April, Chris. Thank you for
• 11:27
  your time.