Latest / Becker’s Healthcare - Clinical Leadership Podcast / Mara Nitu, Vice President and Chief Medical Officer at Indiana University School of Medicine and Riley Hospital for Children, IU Health

Transcript

Mara Nitu, Vice President and Chief Medical Officer at Indiana University School of Medicine and Riley Hospital for Children, IU Health · Becker’s Healthcare - Clinical Leadership 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,
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  Cleveland Clinic, CommonSpirit and more, the conversations get
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  real. Leaders will share how their scenario planning
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  for policy shifts, breaking through value based care
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  barriers, and building clinical teams that translate
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  event
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  details,
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  visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right.
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  This is Laura Dirda with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Mada Nitsu, who's the vice president and
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  chief medical officer at Indiana University School of
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  Medicine and O'Reilly Children's Health. Doctor Nitsu, it's
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  a pleasure to have you on the podcast
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  today.
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  My pleasure is mine.
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  Fantastic. Well,
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  I'm excited for our conversation because I know
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  there's so much happening at IU Health, and
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  it'll be really truly amazing to hear some
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  of the cool things you've been doing over
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  the last year as well as how you're
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  thinking about the future. But before we dive
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  in, can you tell us a little bit
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  more about yourself and Riley Children's Health?
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  Oh, absolutely. So,
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  I have
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  been serving as a chief medical officer at
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  the Riley Children's Health for the last three
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  years, but I, have been a physician here
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  in,
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  this institution for twenty five years of my
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  career
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  and,
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  have
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  enjoyed every single moment.
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  Fantastic. You know, that's, amazing career you've had
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  there. And when you think about especially the
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  last year or so, could you tell us
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  about initiative that you led? What did you
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  do, and what were the results?
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  The biggest,
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  buckets of areas that we are focusing
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  on at the moment are,
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  care coordination and access to care for for
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  all patients,
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  and
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  improving quality
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  specifically by eliminating
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  hospital acquired harm.
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  If,
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  I am to focus on the
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  latest one of the two projects, We've been
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  very successful in reducing hospital acquired harm.
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  And, specifically,
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  as an example, for the CLABSI, for the
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  central line associated line infection,
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  we were able to decrease the infections,
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  to a standardized
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  infection rate
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  of point five one, which has been the
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  best we've
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  been able to perform,
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  for,
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  ever since 2019.
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  So,
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  very, very happy to see that
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  we are gaining those outcomes.
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  Well, that's amazing to hear. And, you know,
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  when you look at that type of,
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  outcome, that transition and being able to really
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  reduce that hospital,
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  acquired harm,
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  What did you how did you,
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  change the mindset in processes and workflows? What
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  did you do on the,
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  clinician and clinical level
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  to achieve those results?
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  It takes a village,
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  as you as you are suggesting with your
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  question.
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  And,
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  really hardwiring,
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  high reliable
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  organization,
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  high high reliable
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  mindset
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  takes a number of interventions. So I would
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  say the most successful
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  first
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  step was creating
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  a hack committee, which,
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  stand for hospital acquired condition committee.
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  And we have
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  we have asked a leader, a diet, a
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  physician,
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  nurse diet leader
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  to lead each one of these hack committee.
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  And we have one for central line associated
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  infection, one for
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  catheter associated urinary tract infection, one for,
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  accidental
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  unplanned extubation,
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  and so in medication errors and so on
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  and so forth. So every single one of
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  the hospital acquired conditions harm,
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  get a hacked committee.
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  And then underneath those team leaders,
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  we've built up
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  teams from the,
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  participants
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  from the main areas that would be at
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  higher risk to acquire those infections.
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  And this is
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  a systematic way to
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  build make sure that we are adhering to
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  the standards of nursing practice that that are
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  the standard of care that are
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  well accepted, the bundle of care, and
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  then continue to,
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  improve the high reliability
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  there and really
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  patient with failure. And, moving from reactive to
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  predictive has been
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  probably the biggest accomplishment that led to those
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  outcomes.
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  That's helpful to understand and, you know, definitely,
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  seems like that systematic process and then having
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  the dyad leaders come together and, really be
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  accountable for those outcomes makes a big difference.
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  That's really cool to hear.
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  Now looking ahead,
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  what are some of the big priorities and
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  headwinds that you're focused on for 2026?
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  I think the biggest priority will will be
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  to continue to
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  to work on the heart prevention, but we
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  are,
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  doubling down on,
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  optimizing
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  access care coordination
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  and,
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  really
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  throughput and length of stay.
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  With the Medicaid reform, we are,
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  expecting that,
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  payment model is going to,
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  be restructured. And with that, we we are,
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  preparing we are working very hard to adapt
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  to the new model and to be able
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  to become even more efficient in the way
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  we move patients through the continuum. We focus
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  a lot on the length of stay and
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  readmission. We definitely would not want to discharge
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  patients sooner than they already, such that we
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  have more readmission.
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  But just in time,
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  it's
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  what we are focusing through. So really access
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  and throughput would be probably the biggest priority
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  for this year.
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  That's helpful to understand. And I think especially
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  through the lens of some of those changes
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  that are coming down the pipe with insurance,
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  Medicaid reform, and other areas that could be
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  challenging
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  to for for folks to access care in
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  the way they used to.
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  And so, you know, when you're thinking about
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  access,
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  in general, and
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  I I know we touched on a little
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  bit, obviously, traditional access points as well as
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  looking at, you know, digital and more.
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  What does it take for the system as
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  well as clinicians,
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  on their level to, really think differently and,
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  be ready,
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  to make the necessary adjustments so that patients
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  can still have access to the care that
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  they need?
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  It's a very good question,
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  and it's a multifaceted,
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  effort that needs to be put in place.
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  I think the biggest
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  point for the physician is to be able
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  to have to to to to be certain
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  that the patient has the ability to receive
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  the care that they need
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  outside of the hospital and specifically the follow-up.
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  We've put together on
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  a number of,
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  different models that are looking to the most
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  complex patient discharges,
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  particularly for those who live very far away
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  from our institution because, obviously, we serve the
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  entire state of Indiana and and beyond.
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  And a lot of our patients travel two
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  to three hours to to come to our
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  institution. So discharging
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  one patient like that poses more challenges
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  than one who would be right next door,
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  lock located in you know, close by the
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  by our facility.
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  And,
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  just, we've put together models in which sometimes
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  we discharge the patient to a nearby,
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  for just for a night or so for
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  the family to feel comfortable to do so.
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  Or we do a lot of patient care,
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  parent care,
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  in the hospital prior to discharge, working with
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  the home,
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  care,
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  organizations to make sure that the family receives,
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  at home the the help and the support
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  that they need.
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  So it there is a lot of care
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  coordination
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  that gets packaged behind these,
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  these these charges that is very, very important
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  to get it right.
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  That makes a lot of sense. Thank you
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  for digging a little bit deeper there. Now
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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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  The hardest thing? I really think getting this
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  done right is not easy.
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  And then,
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  if I want to dive a little bit
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  deeper in this, it's probably the behavioral health
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  and the care coordination in that patient population.
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  And I think that's difficult solely because,
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  of the increasing
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  epidemic that we see with behavioral health and
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  the fewer resources that are available within health
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  care for those patients.
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  So how do we wrap our mind
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  around supporting the patients who have an added
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  layer of complexity that comes from behavioral health
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  standpoint? It's
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  it's,
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  one area in which we will need to
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  partner with the entire community to be able
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  to deliver that because partnering with the schools,
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  partnering
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  with all resources
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  is going to be crucial
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  to to be able to develop a model
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  that's sustainable.
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  That makes a lot of sense. I I
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  think, you know, it's so difficult to try
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  to understand all the dynamics coming into behavioral
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  health and where it can actually make the
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  biggest impact when you're looking at the population,
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  when you're looking at how you want to
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  not only improve outcomes, but also make sure
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  that you're running the system efficiently on the
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  operational and financial side. So I think that's
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  a huge,
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  challenge and question for so many leaders across
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  the country. And,
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  you know, I can imagine from your seat
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  too, in in being,
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  focused very much on on the patients and
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  the outcomes,
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  you know, it takes a lot of work
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  and coordination,
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  and connection with your executive team to make
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  this happen.
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  Yeah. And,
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  if I may add
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  to that particular point,
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  one
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  physical space we are developing as we speak,
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  and, hopefully, we are going to go live
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  with it by midyear
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  twenty twenty six,
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  is
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  a, medical
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  behavioral
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  health unit.
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  What that is is a unit in which
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  patients who have behavioral health needs are going
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  to be admitted,
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  but in addition,
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  they would also have medical medical,
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  care needs.
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  Because currently, those patients are admitted in the
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  regular medical floor, and they don't have access
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  while they receive medical care. They don't have
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  access to the behavioral health programming.
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  So we are building a unit that is
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  going to be able to deliver both aspects
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  of care in the same time.
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  And,
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  would be one of the
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  few such units in the country, and we
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  are partnering and learning from those who have
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  one that's already established
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  to see how to launch it to make
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  it safe and effective.
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  Absolutely. I think being able to learn from
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  others is always a really,
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  important,
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  aspect of health care and partnering on a
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  deeper level,
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  especially now more than ever is critical.
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  Now before we wrap up, I want to
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  ask you about growth as well. Where do
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  you see some of the best opportunities for
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  organizational growth going forward?
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  The biggest growth opportunities that we see are
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  in,
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  improving access. We we have
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  a lot of patients who are
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  hoping to receive care from our organization, but
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  our access, meaning the time that one needs
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  to wait to get an appointment in the
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  outpatient space,
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  sometimes doesn't meet the needs of the family.
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  So trying to think of, creative model to
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  optimize that and then make sure that we
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  are meeting the family needs in terms of,
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  providing fast and prompt and effective care for
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  those families, it's one of the opportunity. The
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  other opportunity is,
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  in the area of creating new models of
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  care. So,
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  a lot of work is being done in
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  terms of,
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  programs of national excellence and creating those destination
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  programs in which,
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  the entire team is focusing and thinking about
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  that particular condition,
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  and,
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  brings innovation in the way we are treating
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  the patient. So I think,
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  being able to be at the innovation
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  side of things in terms
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  of complex conditions and patients with,
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  orphan illnesses or even illnesses that are frequent
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  enough but require more of a care coordination
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  is one side of things, and the other
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  is just access for all and being able
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  that we meet the needs of the patients
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  and the families in terms of getting them
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  in.
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  Absolutely.
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  Access access access is such a huge it
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  seems like theme of the year,
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  across the board. And so, you know, to
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  understand in a a better way how you're
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  thinking about that and finding those creative models
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  and and problem solving, in real time is
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  just really cool to hear. Thank you so
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  much for joining us on the podcast today,
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  doctor Ninsu. It's been such a fun conversation.
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  I I've learned a ton and look forward
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  to continuing,
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  our conversation as well at the annual meeting.
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  I know you'll be speaking on a panel
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  there, and, it'll be truly fantastic to hear
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  from you and, just continue to learn more.
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  Thank you so much for your time, Laura,
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  and I've enjoyed having this conversation with you
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  as well.