Latest / Becker’s Healthcare - Clinical Leadership Podcast / Navneet Dang, Chief Medical Officer at Geisinger Community Medical Center

Transcript

Navneet Dang, Chief Medical Officer at Geisinger Community Medical Center · Becker’s Healthcare - Clinical Leadership Podcast

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  This is the Becker's Healthcare Podcast created by the team of Becker's
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  Four new 15 minute episodes are released daily containing industry news analysis
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  Thanks for listening. Now here's the episode.
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  Welcome everyone to the Becker's Healthcare podcast series. I'm Rah Mohammed,
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  writer and moderator with Becker's Healthcare.
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  I'm absolutely thrilled to have with me today Dr. Nav. Dang,
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  chief medical officer at Geisinger Community Medical Center. Doctor,
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  it's very nice to have you on the podcast today. How are you?
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  I'm good.
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  Thank Great, great. Glad to have you on. To get us started,
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  would you mind please introducing yourself and telling us a bit about your
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  background and organization?
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  Yeah, thank you Mariah, for the opportunity and uh,
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  it's my pleasure to be here. So my name is Nni Dan.
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  I have been in healthcare for about 25 years and at
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  Geisinger for about eight years.
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  I'm an internal medicine physician and have been in various leadership
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  positions within Geisinger Health.
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  Most recently as system chief quality officer,
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  where I led efforts around patient safety and quality across
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  inpatient areas across 10 hospitals and system
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  chair of inpatient medicine as well.
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  I currently serve as the Chief Medical Officer at Geisinger Community Medical
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  Center in Scranton, Pennsylvania.
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  Our campus is a level two trauma center with close to
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  290 beds and is one of the teaching sites
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  for Geisinger Commonwealth School of Medicine medical students,
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  various residencies and fellowship programs.
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  A brief introduction about Geisinger Health as a health system.
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  Geisinger is an integrated healthcare delivery model with a strong
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  focus on value-based care.
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  We take pride in taking care of our patients through the whole continuum of
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  care. Our vision is making better health,
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  easier for the patients and communities we serve.
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  Geisinger is focused on three key strategic priorities,
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  which are managing total health, operational excellence,
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  and access and ease of use.
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  Good, wonderful.
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  Thank you so much for giving us that background on you and your organization.
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  Um, the first question that I really wanted to ask you, doctor,
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  is can you tell me about your most successful project or initiative from the
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  last year? What issues were you trying to solve and also what drove the success?
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  Yeah, thank you Maria for the question. Um,
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  so there are couple of initiatives that come to mind, which I would,
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  uh, like to share today.
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  Our teams at Geisinger are laser focused on improving quality,
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  patient safety and patient experience for our patients and the communities
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  we serve.
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  We have embarked on a journey to zero harm and worked
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  extremely hard to reduce preventable harm.
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  There has been a significant focus on reducing and
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  preventing patient harm across the clinical enterprise.
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  One initiative that comes to mind is our work around reducing
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  central line associated bloodstream infections across the system.
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  We assembled a multidisciplinary team of clinicians,
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  which included physicians, nursing staff,
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  infection control team, and our vascular access team,
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  and created a system task force.
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  We used our proven care approach and standardized our
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  insertion and maintenance practices for central line care.
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  We also created an escalation process to get central lines out
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  in a timely manner.
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  The root cause analysis process helped us to discover
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  areas of opportunity and develop appropriate action plans.
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  We closely tracked compliance of our process measures and
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  created an audit process which led to about 50%
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  reduction in central line associated bloodstream rate across all our
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  hospitals in Scranton.
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  At Geisinger Community Medical Center.
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  We had eight months without a central line associated
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  bloodstream infection this year and have also seen significant
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  improvement in primary bloodstream infection as well.
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  We are also seeing significant improvements in our catheter
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  associated urinary tract infections.
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  Hospital acquired c diff infections and went associated pneumonia rates
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  because of our JO journey to zero harm.
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  The second initiative that I would like to talk to you
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  about today,
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  there is a significant focus on value-based care across the
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  organization. During covid,
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  we saw a significant challenge with inpatient mobility
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  for our patients due to isolation and some of the other challenges
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  in terms of taking care of our covid patients. As such,
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  our physical therapy and nursing teams worked diligently to
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  refine mobility efforts at the campus.
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  We instated a mobility challenge,
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  which awards the unit who has the highest number of steps with
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  a golden sneaker award.
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  We have more than tripled the total number of steps currently and we continue
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  to improve.
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  This has enabled us to improve patient outcomes and decrease
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  post-acute utilization.
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  Our skilled nursing facility and inpatient rehab facility
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  utilization post discharge has been below benchmark
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  and because of these efforts,
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  we are able to discharge 80 to 85% of our
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  patients home from the hospital.
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  This has also enabled us to have top
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  desire performance in bundles, payment care improvement,
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  advance initiative by C M s,
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  which really focuses on value-based care and cost of and total cost
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  of care. So that was, um,
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  two initiatives. The third one that I would like to describe,
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  which has been very successful in improving access within the hospital
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  and re represents one of our strategic objectives,
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  is our efforts concerning length of stay and throughput.
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  We have been able to improve our length of stay by 15
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  to 20% by instituting multidisciplinary
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  rounds, which we call boost rounds on each unit.
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  A greater representation of the inclusive culture at Geisinger
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  is that members of our care team come together and design care plans
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  alongside our clinicians.
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  Some epic tools in place such as expected day of discharge
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  and medically ready buttons keep our care teams focused
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  on proactive discharge planning from the time of admission.
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  To answer your question, Maria, about what drove success.
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  So couple things there.
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  We have developed a unit-based diode leadership model,
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  which we call accountable care unit model,
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  where a physician and nursing leader dyad work together
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  towards driving change and improving clinical outcomes.
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  The secret sauce, in my opinion,
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  is high reliability organization methodology and
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  multidisciplinary approach to caring for our patients.
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  So those were some of, um, the initiatives, uh,
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  and also, um,
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  some of the key areas that helped us to drive
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  success.
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  Wow, that is totally wonderful.
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  Thank you so much for sharing those three initiatives. As you know,
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  the clinical workforce has changed a lot in the last few years.
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  What challenges are you still facing and how do you see the clinical workforce
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  evolving?
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  Yeah, thank you. Uh, Maria, this is another great question.
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  Let me take a stab at this. Um, and I'm not sure if you,
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  um, looked at the Medscape survey report from 2023,
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  but about 52% of physicians reported
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  experiencing burnout,
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  which is a negative change from 2018 numbers at
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  42%.
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  So there has been 10% increase in physician
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  burnout. Um, in last five years,
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  23% physicians reported depression,
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  which is again a worsening statistic from 2018 at
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  15%,
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  61% physicians reported that too many bureaucratic
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  tasks is the number one reason for burnout and lack of
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  respect from coworkers at 36% is the second
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  reason. Second most common reason for physician burnout.
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  In my opinion,
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  clinician burnout is the biggest challenge and burnout was present even
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  before covid, but COVID has significantly worsened it.
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  There is a lot of focus from our system on
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  clinician wellbeing and there are many programs developed at
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  Geisinger to support clinician wellbeing.
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  We are not leaving the burden of solving this issue just on our clinical teams.
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  There are system solutions being developed for this particularly
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  critical issue.
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  Our chief wellness officer at Geisinger is leading
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  different work stream to improve clinician burnout
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  in terms of clinical workforce evolvement.
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  I feel programs like virtual nursing,
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  telehealth services and AI can significantly
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  help to improve access to care.
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  Human touch and patient-centric approach is still going to be the key,
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  but AI and digital tools to improve patient outcomes will
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  be crucial to evolving the healthcare space.
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  So those were some of the thoughts I had.
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  Absolutely. Thank you so much for sharing that insight. And Doctor,
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  before I let you go,
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  the last thing I wanted to ask you is what is your best advice for aspiring
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  physician and nurse leaders?
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  Another great question.
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  So I would say that time spent at bedside caring for
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  patients is critical.
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  My advice for aspiring physician and nurse leaders
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  would be to commit to lifelong learning
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  because I believe that leadership is an acquired skill
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  and our aspiring leaders must commit to be lifelong learners.
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  Another thing I feel about leadership,
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  it's a huge responsibility and humility and empathy
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  are key to becoming a successful leader.
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  So those would be some of my thoughts. Maria.
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  Wonderful, wonderful. Thank you so much for those final thoughts, doctor.
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  This has been an amazing and informative discussion. So I, again,
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  I wanna thank you so much for coming on Becker's Healthcare and I look forward
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  to connecting with you again soon.
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  Thanks again for the opportunity. I appreciate it.
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  Of course.
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  It's so important for leaders at the top of organizations to keep learning,
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  stay sharp,
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  grow their networks to help our audience better do this in a more simplified,
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  personalized, and meaningful way. Becker's Healthcare has launched my bhc,
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  charge@www.my.hospital review.com
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  and we'll see you there.