Latest / Becker’s Healthcare Podcast / Reducing Clinical Variation to Improve Patient Outcomes with Dr. Harpreet Pall

Transcript

Reducing Clinical Variation to Improve Patient Outcomes with Dr. Harpreet Pall · Becker’s Healthcare Podcast

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  The most important health care decisions don't happen
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  in isolation.
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  They happen when leaders come together.
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  Becker's sixteenth annual meeting brings together more than
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  3,500
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  hospital and health system executives this April in
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  Chicago.
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  With 800 speakers from Ascension, Cleveland Clinic, CommonSpirit
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  and more, the conversations get real. Leaders will
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  share how their scenario planning for policy shifts,
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  breaking through value based care barriers and building
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  clinical teams that translate new ideas into real
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  world care.
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  Join top decision makers in the room April
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  13 through the sixteenth.
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  For the agenda and event details, visit beckers
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  hospital review dot com and click on the
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  events tab in the upper right.
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  This is Laura Dirdle with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Harpreet Paul, chief medical officer at Hackensack
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  Meridian Jersey Shore University Medical Center and k
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  Hovnanian
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  Children's Hospital, as well as professor of pediatrics
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  at Hackensack Meridian School of Medicine. Doctor Paul,
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  it's a pleasure to have you on the
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  podcast today.
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  It's such a pleasure to be here with
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  you, Laura. Thank you. Absolutely. Now I'm excited
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  for our conversation. I know we'll talk a
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  little bit about some of the cool things
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  that you've been doing over the last year
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  or so as well as your perspective on
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  the future. But before we dive in, can
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  you tell us a little bit more about
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  yourself and your organization? Absolutely. I'll tell you
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  first a little bit about Jersey Shore University
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  Medical Center. We're a large academic medical center
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  in New Jersey. We're located in Neptune, New
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  Jersey, and we're one of the
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  academic hospitals within, Hackensack Meridian Health.
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  We've got a diverse patient population in Monmouth
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  and Ocean Counties, and we're also a referral
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  center for complex care.
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  So we're a level one trauma center for
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  both adults and children.
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  We've got advanced cardiac care, oncology,
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  neuroscience,
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  and, children's hospital as well, Cajobanian Children's Hospital.
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  In my role
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  as CMO,
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  it it's really at the intersection of,
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  leadership for our physicians,
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  clinical quality,
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  hospital operations. A lot of my time is
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  spent working with our clinical teams to
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  really look at how care is delivered across
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  the hospital and across the continuum
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  and see how we might be able to
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  enhance that from
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  patient safety and outcomes to
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  performance and innovation.
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  I'm also a practicing pediatric gastroenterologist,
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  and I'm also,
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  very much engaged in our academic activities at
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  our medical school. So I'm,
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  remaining closely connected to both our clinical and
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  academic missions.
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  That's amazing to hear. And, you know, really
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  cool to understand where you're positioned in the
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  community and how you're, really continuing to serve
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  them well. Now can you tell me about
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  the most important initiatives that you led in
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  the last year? What did you do and
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  what were the results?
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  Well, one of the,
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  areas that we've had a focus on is
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  clinical variation
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  across the hospital. And the goal has been
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  straightforward,
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  ensuring that the patients we serve get the
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  consistent right care at the right time in
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  the right setting
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  while we're focusing on reducing that unnecessary
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  variation. And as you know, sometimes when you
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  have that variability,
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  that can drive longer
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  hospital stays,
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  higher costs, and lead to,
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  inconsistent outcomes.
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  So what we did, as one of our
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  focus areas is
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  ensure that
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  the multidisciplinary
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  teams
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  across the service lines that we have
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  are really drilling into areas like readmissions,
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  efficiency of our discharge processes,
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  care pathways for some of our high risk
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  conditions like heart failure or
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  COPD and pneumonia.
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  An example
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  that really highlights some of this work is
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  how we've looked at our multidisciplinary
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  rounds that take place on a daily basis
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  and
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  see what the opportunities were for redesigning them.
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  Historically,
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  in healthcare, sometimes these Multidisciplinary
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  Rounds or MDR Rounds
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  can become somewhat of a reporting exercise.
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  So our team's focused on redesigning the process
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  so that the attending physician leads the discussion
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  and the entire care team aligns
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  around a clearly defined expected discharge date.
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  And when that happens consistently,
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  you know, that leads to better coordination
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  across the clinical teams and case management.
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  It can lead to improved
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  flow of patients,
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  avoiding unnecessary
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  delays,
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  and really, very importantly, gives patients and families
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  better expectations about their care journey.
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  Sounds kind of, simple, but when implemented well,
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  it can have a very significant impact. So,
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  you know, it's that that clinical variation
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  reduction isn't about isn't
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  about
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  restricting physicians and clinical teams. It's really about
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  making sure that every patient gets the best
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  evidence based care every time.
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  I love that. I I think it's such
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  an important distinction because understanding that and having
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  that why out there, I can imagine, it
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  really helped the teams get behind the changes
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  you were trying to make and see a
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  better and more efficient process for caring for
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  patients and their outcomes. And, you know, I'm
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  curious when you're going through all of that,
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  what type of,
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  change management did it take to do that
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  with the teams? Who was involved? And how
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  did you really get to the place where
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  you're seeing the results that you were hoping
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  for?
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  Yeah. It's, you know, it it it it's
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  really ensuring that the teams have a
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  a voice and that they're engaged in the
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  process. I think that with especially around complex
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  change like this, these are not simple,
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  interventions that we're,
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  trying to deploy. We we've got, at a
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  large scale, a lot of
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  change and progress that needs to happen to
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  deal with the complexity and the acuity of
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  the patients that we're serving.
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  So I think the most important part of
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  this is ensuring that the teams are engaged
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  in the process,
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  that we take their ideas and we incorporate
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  them into the planning that we have.
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  And that leads to them being bought into
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  the process and owning it as well. So
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  I think that that's really the key
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  that we take the multiple perspectives, that three
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  sixty view of the issues that we're dealing
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  with, which are very complex issues.
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  They're not
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  silos. Healthcare is one care model
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  and,
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  you know, making sure that the nurses, the
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  doctors, the case managers, dietitians, and pharmacists, all
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  the
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  frontline teams who have a a voice in
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  this, who have a stake in the outcomes,
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  have a seat at the table and are
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  able to contribute
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  and give their perspectives so that ultimately we
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  can come up with the best model and
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  the best approach
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  to deliver the the
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  amazing outcomes that our teams deliver on.
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  That's fantastic to hear. Thank you so much
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  for digging a bit deeper there. Now I'm
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  curious. I'm looking ahead to 2026. What are
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  some of the, big headwinds as well as
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  opportunities that you're looking at? What are your
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  priorities heading into the next few months or
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  so?
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  Laura, there's a a few key,
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  priorities. So,
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  the first is really
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  continuing to focus on the throughput and the
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  patient flow
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  while we're maintaining the highest standards of quality
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  and safety.
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  We we already know that hospitals across the
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  country are facing capacity challenges, and addressing that
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  requires a really tight coordination
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  across the emergency
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  departments, our inpatient
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  care teams, and also the post acute transition.
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  So
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  that is, definitely gonna continue to be a
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  major focus.
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  I'd say another
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  priority is continuing to expand the
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  care delivery beyond the traditional
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  hospital walls,
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  and programs like hospital at home,
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  virtual or remote monitoring,
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  and some of our digital care platforms
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  are gonna allow us to deliver high quality
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  care while improving access and experience. So
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  that trend I think is gonna continue and
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  that's an area for our focus as well.
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  I'd say a third is in physician and
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  clinician engagement.
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  None of these initiatives succeed
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  unless those frontline teams feel a strong sense
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  of ownership in improving,
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  how that care is delivered. And a big
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  part of my role as the CMO
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  is creating a structure where these clinical teams
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  help lead these efforts,
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  rather than feel that,
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  our initiatives are simply being imposed on them,
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  and we touched on that before. So,
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  you know, all of this is in the
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  backdrop of the headwinds that are,
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  that many health systems are facing across the
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  country.
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  Workforce shortages,
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  regulatory complexity,
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  financial pressures,
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  that all come with caring for these increasingly
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  complex,
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  patients. So,
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  you know, to to sum it up that
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  I I I think that health care leaders
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  today have to think beyond the walls of
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  the hospital, and the real
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  opportunity is designing a system of care that
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  meets patients where they truly are.
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  Got it. That's so helpful to understand and,
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  you know, really interesting to hear all of
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  those different aspects we're intertwined together.
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  What do you think the hardest thing you'll
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  have to do in the coming year will
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  be?
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  Well, it it's it's also where the biggest
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  opportunity is. So the hardest part of health
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  care leadership right now is leading meaningful change
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  in a very complex environment.
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  Hospitals are very sophisticated.
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  We've got thousands of people working together from
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  physicians and nurses, administrators
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  to support teams.
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  So when we're talking about quality and performance
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  improvement,
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  we really need alignment across all of these
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  different groups.
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  And for me the hardest work, but also
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  the most important, is building consensus
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  around
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  some of these operational changes like standardizing care
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  pathways,
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  looking at our discharge processes,
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  and implementing new care models.
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  And that requires trust, it requires us to
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  be transparent with our teams, and also strong
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  clinical leadership.
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  But when that alignment happens, it's like magic.
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  The impact on the patients that we serve
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  and the culture that we have can be
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  absolutely fantastic.
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  I love that. And I think especially thinking
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  about how leadership can truly, you know, transform
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  with some of these,
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  transparency
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  and and and really being clear about how
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  they're going about things and what will make
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  a big difference, for them in the future
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  is key. Now before we wrap up here,
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  I wanted to ask about growth too. Where
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  do you see some of the best opportunities
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  for growth?
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  There's a,
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  a few
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  key areas. The first is
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  continuing to expand access to highly specialized care.
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  For us as a
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  destination academic medical center, we're continuing to grow
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  programs in
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  advanced cardiac care, in our children's hospital,
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  neuroscience,
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  oncology,
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  and complex surgery.
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  Patients are increasingly
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  seeking out centers of excellence for these complex
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  conditions and having that multi disciplinary
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  team,
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  is really important. So those Centres of Excellence
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  is definitely one area.
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  Another,
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  major opportunity is looking at how care is
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  delivered and whether there's opportunities to redesign that.
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  You know, patients are expecting health care to
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  be
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  accessible, to be coordinated, and more so now
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  digitally enabled as well. And,
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  these programs, these innovations like remote monitoring, hospital
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  from home, virtual specialty care allows us to
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  touch more patients and manage chronic disease more
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  effectively.
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  The third major opportunity,
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  is the ambulatory expansion.
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  You know, that is really
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  a critical part of our
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  strategy as care shifts to the ambulatory
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  setting.
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  And and I think at the end of
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  the day, the organizations
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  that really combine strong clinical programs with innovation
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  and how care is delivered are gonna be
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  positioned really well for the future.
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  That's amazing to hear, and I'd agree. I
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  mean, it's so much is happening within how
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  you're looking at care. The ambulatory space is
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  making a a big impact right now. So
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  I love that focus and drive it and
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  seeing growth potential there. Doctor Paul, thank you
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  so much for joining us on the podcast
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  today. This has been such a fun conversation,
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  really to truly get behind some of the
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  things that have really made you successful,
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  in how you're thinking about the next steps.
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  So, thank you for your time today, and
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  I look forward to
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  seeing you as well at our annual meeting.
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  I know you'll be speaking on a panel,
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  coming up here in a couple of weeks
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  in April. So excited to catch up there.
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  Thank you so much, Laura. It's been a
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  lot of fun, and I'm excited to to
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  be at the meeting and to meet you
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  as well.