Latest / Becker’s Healthcare Podcast / Driving Surgical Efficiency and Culture Change with Dr. Paula Ferrada

Transcript

Driving Surgical Efficiency and Culture Change with Dr. Paula Ferrada · Becker’s Healthcare Podcast

• 0:00
  This is Scott Becker with the Beckers HealthCare
• 0:03
  podcast. I am thrilled today to be joined
• 0:05
  by an absolutely brilliant physician leader, but we're
• 0:08
  joined today by doctor Paula Firatta.
• 0:11
  And doctor Firatta is the department of surgery
• 0:13
  chair at Inova Fairfax Hospital.
• 0:17
  Doctor Farada, it it will talk today about
• 0:20
  operational efficiency,
• 0:22
  about a number of the tools that you're
• 0:24
  using, how you're approaching things, and a lot
• 0:26
  more. But but before we do that, can
• 0:28
  you take a moment and tell us about
• 0:31
  yourself and a bit about your work and
• 0:34
  and your background?
• 0:35
  Thank you. Thank you so much, Scott. Thank
• 0:37
  you for having me. I'm really excited about
• 0:39
  this episode.
• 0:40
  I am a trauma surgeon by training, and
• 0:42
  I'm the chair of surgery at Inova Fairfax.
• 0:45
  We are a 920
• 0:47
  licensed bed hospital with about 60 operating rooms
• 0:51
  that we oversee.
• 0:53
  It's a large high acuity healthcare system in
• 0:55
  Northern Virginia, Inova Health. We serve a population
• 0:58
  of 3,200,000
• 0:59
  people. We manage a significant volume of complex
• 1:02
  surgical care.
• 1:04
  My work
• 1:05
  sits at the intersection of clinical care, surgeon
• 1:08
  engagement, and operational leadership, ensuring that our teams
• 1:11
  can deliver timely, high quality care to our
• 1:14
  patients.
• 1:15
  I am personally particularly
• 1:17
  passionate about helping surgeons engage with innovations,
• 1:21
  and this includes also AI tools,
• 1:23
  also to improve access for our patients, increase
• 1:26
  operating room efficiency in patients' outcomes, which is
• 1:29
  our mission as healers.
• 1:31
  Over the past year, I have been closely
• 1:33
  involved in supporting our systems transformation
• 1:35
  for operating room access and utilization
• 1:38
  along our perverted teams and also partners with
• 1:41
  lean tasks as well.
• 1:43
  It it it it's simply remarkable. And and
• 1:45
  you've had this fascinating background from University of
• 1:48
  Miami to your residency at Harvard to a
• 1:51
  couple different fellowships.
• 1:53
  Talk a bit about some of your background
• 1:54
  and and how it's prepared you for what
• 1:56
  you're doing today.
• 1:58
  And and one, we've got a stepdaughter that's
• 2:00
  at University of Miami Medical School, so we
• 2:02
  relate to that. Two, we're big fans of
• 2:04
  Harvard. Tell us about those experiences and about
• 2:06
  fellowships and more. Oh, thank you for the
• 2:09
  opportunity to tell my story.
• 2:11
  I think looking back, everything that I had
• 2:13
  to go through prepared me to be here
• 2:15
  right now. I I believe, I mean, my
• 2:17
  dream job is a good fit. I'm happy
• 2:19
  every day.
• 2:20
  I was born in Colombia, South America,
• 2:23
  and I didn't know that I was gonna
• 2:24
  end up in The United States. My
• 2:26
  dad, was a very well known surgeon where
• 2:29
  I grew up in Cali, Colombia. My mom
• 2:31
  was a chief nurse.
• 2:33
  So I I was I didn't plan to
• 2:34
  come to The United States, but I ended
• 2:36
  up coming after
• 2:38
  my medical school training. And in medical school,
• 2:40
  I did mostly trauma because Cali, Colombia at
• 2:43
  the time was if you were a surgeon
• 2:44
  or a or a physician, you were you
• 2:46
  were taking care of trauma patients. That's why
• 2:48
  I think trauma chose me rather than the
• 2:51
  other way around.
• 2:52
  I came as a foreign graduate to University
• 2:54
  of Miami where I did some research. I
• 2:56
  did preliminary
• 2:58
  couple of preliminary years, then I did, my
• 3:00
  residency at the Cathedral Deaconess
• 3:03
  one of the major Harvard teaching hospitals.
• 3:06
  I learned a lot. I learned I learned
• 3:08
  a lot, not only surgical part, but I
• 3:10
  learned a lot about leadership.
• 3:11
  Now retrospectively,
• 3:12
  you know, leadership is not taught in medical
• 3:15
  school or in residency,
• 3:16
  But retrospectively,
• 3:17
  I learned a lot from the beginning just
• 3:20
  trying to immerse myself in the American culture,
• 3:23
  understand how the systems here
• 3:25
  work differently. And because I didn't take any
• 3:27
  of that for granted, it was a steep
• 3:29
  learning curve for me, which I am grateful
• 3:31
  for. Then I went to Pittsburgh and did
• 3:33
  my critical care fellowship. Then I went to
• 3:35
  shock trauma, and then, I was their first
• 3:37
  acute care surgery fellow.
• 3:39
  Then I moved to Virginia Commonwealth University in
• 3:42
  Richmond where I spent eleven years. You know?
• 3:45
  I went from assistant to associate to professor,
• 3:47
  director of the the intensive care unit and
• 3:50
  and, the fellowship, and I came to Inova
• 3:53
  in 2021
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  as division and system chief for trauma.
• 3:56
  I took over preparative services in 2024
• 3:59
  for Fairfax Hospital, and then I took over
• 4:02
  as chair of the department of surgery in
• 4:04
  2025.
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  But it has been a great professionally, it
• 4:07
  has been a great journey for me. I
• 4:10
  can tell you and
• 4:12
  because I love iNova and what we stand
• 4:15
  for and the culture that we have built,
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  I am very excited. I have always been
• 4:20
  very excited of being a surgeon and treating
• 4:21
  patients.
• 4:23
  Now that I discover that I am actually
• 4:26
  good at what I do in terms of
• 4:27
  leadership and helping people and transformation and changing
• 4:31
  culture.
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  It is it is so motivating to me.
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  I read something about leadership every day. I
• 4:37
  show up to work every day super happy.
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  I love where I'm at right now. I
• 4:40
  think,
• 4:41
  not only the job, but the institution is
• 4:43
  a good fit. We're a good fit for
• 4:45
  each other.
• 4:46
  It's fantastic. And Inova is a fantastic system.
• 4:48
  I think doctor Jones is still the CEO
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  of Inova.
• 4:51
  Yeah. Steven Jones and and a fantastic leader,
• 4:54
  just fantastic.
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  And so a great system a great mid
• 4:58
  sized system where you could still really be
• 5:00
  close to leadership, really be close to people
• 5:02
  and your community. So it it literally a
• 5:05
  fantastic system. We love it.
• 5:07
  Talk about the perioperative
• 5:09
  team.
• 5:10
  Over time, the perioperative team at Novus talked
• 5:13
  about, you know, different challenges everybody faces, OR
• 5:16
  block underutilization,
• 5:18
  scheduling bottlenecks,
• 5:20
  limited access to the data you need.
• 5:23
  For leaders who are navigating these types of
• 5:25
  pressures, blocks that gotta be used better, better
• 5:27
  scheduling,
• 5:29
  getting the right data, can you put those
• 5:31
  challenges in context?
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  What's the real
• 5:34
  problem
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  if systems don't address these? What what happens
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  if systems don't address these problems?
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  I I love how you're phrasing it because
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  it's not only the challenges that we see,
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  it's the challenges that we don't see. The
• 5:46
  unspoken
• 5:47
  truth that percolates
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  between
• 5:50
  phrases and teams that if we don't address,
• 5:53
  then we can never really incorporate change. I
• 5:56
  think the challenge is was for preparative services
• 5:59
  and our team. It was not only about
• 6:01
  the news opening room time. It's about the
• 6:04
  disconnect
• 6:05
  between perceived scarcity and actual access.
• 6:09
  And, you know, making sure that surgeons don't
• 6:11
  feel that they're blocked from scheduling because they're
• 6:14
  very protective of their block times,
• 6:16
  and but at the same time, keeping the
• 6:18
  patient in the center. When scheduling is fragmented
• 6:21
  and data is hard to access,
• 6:23
  it creates a really downstream
• 6:25
  impact to delay care, longer hospital stays, frustrating
• 6:29
  clinicians.
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  And if you have a frustrated surgeon, you
• 6:32
  also have a frustrated nurse and a frustrated
• 6:34
  team. Right?
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  It translates into inefficient use of highly
• 6:38
  valuable or resources
• 6:40
  or operating room time for those that work
• 6:43
  in operate in this space, in preparative space,
• 6:46
  you know, that that's
• 6:47
  that's, like, precious real estate.
• 6:49
  These issues also
• 6:51
  drive cultural friction and and culture actually eats
• 6:54
  a strategy for breakfast in my book.
• 6:57
  Surgeons,
• 6:58
  felt the need to needed to protect log
• 7:00
  time, which limits flexibility and collaboration across the
• 7:03
  system. And if this is left unaddressed, then
• 7:05
  health care systems are essentially leaving
• 7:08
  capacity and patient access on the table while
• 7:10
  simultaneously increasing burnout across teams.
• 7:13
  I think I think that what we did
• 7:16
  very well was
• 7:18
  changing the culture from
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  this is my operating room time, this is
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  my patient, to this is our our operating
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  room time, these are our patients. Because,
• 7:29
  amplifying that view and and and making people
• 7:32
  realize that, again, it's not a scarcity problem.
• 7:35
  Everybody will eventually find time and creating trust
• 7:39
  in between team members.
• 7:41
  But but but your point is so well
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  taken. Aside from frustration of surgeons that don't
• 7:45
  get the time they want,
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  nurses are irritated because now they're working overtime
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  because they're they're sort of somebody's not using
• 7:52
  their block as well as it could. So
• 7:53
  now you're you left that time open, and
• 7:55
  you're scheduling later to get patients in.
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  Patients are frustrated too because if they're not
• 7:59
  getting scheduled and then it gets scheduled, not
• 8:01
  only do they end up they they end
• 8:03
  up ultimately sometimes looking elsewhere too. Their surgery
• 8:05
  gets done at a different institution with different
• 8:07
  surgeons even if it's not the best thing
• 8:09
  to do because you haven't addressed those problems.
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  Talk a little bit about you you've made
• 8:13
  great improvement and moved the needle really well
• 8:17
  on surgical volume, utilization,
• 8:19
  and culture.
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  What's the most impactful
• 8:22
  data insight you've gained
• 8:24
  through your partnership with LeanTos? I know that
• 8:27
  LeanTos is sort of the leader in predictive
• 8:28
  analytics
• 8:29
  and OR efficiency, also infusion centers. What's some
• 8:33
  of the best data that you've gained through
• 8:34
  the LeanTos
• 8:36
  Inova partnership?
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  Well, Scott, I gotta tell you that our
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  partnership with LeanTask was transformational.
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  I think one of the most impactful insights
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  for us is realizing how misaligned our block
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  release timing was with actual scheduling behavior.
• 8:50
  We had operating room time,
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  but it wasn't accessible
• 8:54
  early enough to be used. And then we're
• 8:56
  using IQ for operating rooms. We use data
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  driven recommendations to better align
• 9:02
  the outer release date lines and how advanced
• 9:04
  the cases are actually scheduled,
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  which unblock meaningful capacity across the system.
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  And and when we did, the impact was
• 9:12
  significant. We saw about 20% increase in release
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  operating room time. In nearly half of the
• 9:19
  time,
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  backfill
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  along with measurable gains in prime time utilization.
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  And so the statistics are and and this
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  is I hope you're sitting down because I
• 9:28
  believe that this is amazing also. I've been
• 9:30
  bragging about it a lot, so I'm sorry.
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  But, we have 46%
• 9:34
  release fill rates across operating rooms and endoscopy,
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  and if you look only out of your,
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  it's 51%
• 9:41
  turning open time into book cases.
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  That's amazing. That's just to give just to
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  give people sense of that, that means 50%
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  of the time that would have gone unused
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  then gets used. And in the old days,
• 9:54
  a surgeon might have felt like they just
• 9:56
  owned that box, and nobody's touching that time.
• 9:58
  So that's where you have to change the
• 10:00
  culture too. You get you get great clarity
• 10:02
  on culture and also the data to know
• 10:05
  it's not being used fully that four hour
• 10:07
  block or that two hour block or whatever
• 10:09
  block it is, and we could fill some
• 10:11
  in that way, and and everybody's happy. The
• 10:13
  other surgeons are happy. Even that surgeon's happier
• 10:15
  because now they're busier. The nurses, nothing worse
• 10:18
  than nurses sitting around. It might sound good,
• 10:20
  but it's horrible for culture. And and if
• 10:23
  and if patients can't get in, they're just
• 10:25
  very frustrated, and everybody's frustrated.
• 10:27
  100%. And then we grew the case volume
• 10:30
  by 8% endo and 13%
• 10:32
  for open time requesters,
• 10:34
  and we increased
• 10:35
  prime time utilization by 3%,
• 10:38
  which is great because this helps us with
• 10:40
  efficiency during the core business hours. More importantly,
• 10:44
  I think that it showed us relatively small
• 10:47
  dating form changes
• 10:48
  that when you release time, you can fundamentally
• 10:51
  improve access for surgeons, which means access for
• 10:54
  patients,
• 10:55
  increase throughput, and ultimately get patients treated sooner,
• 10:58
  and patient and people and the team home,
• 11:01
  home earlier too. Right?
• 11:03
  Which is a huge part of everything. People
• 11:04
  get part of their life back. They don't
• 11:06
  they don't burn out as much. I mean,
• 11:07
  there's so many things that cause friction points
• 11:09
  cause burnout, but people regularly having to be
• 11:12
  at the office or at the hospital or
• 11:14
  wherever they react
• 11:15
  longer than they have to be. When they
• 11:17
  know it could be fixed and improved,
• 11:19
  it is so frustrating. And people wanna get
• 11:21
  home and have a chance to decompress,
• 11:23
  see their family or whatever they do, whatever
• 11:24
  they wanna do to get a chance to
• 11:26
  also take care of themselves besides being in
• 11:28
  the Operating Room. Talk a little bit about
• 11:31
  how surgeons you're you're a data driven surgeon
• 11:34
  leader.
• 11:35
  Technology has been a meaningful part of the
• 11:37
  journey
• 11:38
  here. Was it hard for surgeons to to
• 11:40
  swallow using data, making changes? How was it
• 11:44
  received?
• 11:45
  And and how did their attitudes and their
• 11:47
  reactions with the new system change over time
• 11:51
  as you got better and better at rolling
• 11:53
  this out and making impactful changes on volumes,
• 11:56
  usage of time, and more?
• 11:58
  So the answer is, was that a hard
• 12:00
  pill to swallow? Absolutely. Yes. Nobody likes change.
• 12:03
  They people say that they like change until
• 12:05
  they're the ones who have to change. Right?
• 12:07
  So like many organizations, we saw initial skepticism,
• 12:11
  especially about about earlier block release policies, which
• 12:14
  felt like a loss of control, really, for
• 12:17
  surgeons and for their teams. What made the
• 12:19
  difference was pairing the technology with a strong
• 12:22
  clinical leadership and a clear message.
• 12:24
  This is about improving patient access. This is
• 12:26
  about the patient. Put the patient in the
• 12:28
  center. It's not about taking time away. Over
• 12:31
  time, as the surgeons experience this change and
• 12:34
  increase access to operating room time and fewer
• 12:37
  scheduling barriers, and I think that what made
• 12:40
  it so much better is that trust group.
• 12:42
  Like, trust between our administrators, between the surgeon
• 12:45
  teams, between nurses and anesthesiologists,
• 12:47
  all together,
• 12:48
  trusting each other that we're doing the right
• 12:50
  thing for the patient. And when you have
• 12:52
  that trust, then then you'll see slowly. I'm
• 12:55
  not saying this is gonna be like this,
• 12:56
  but slowly, you're gonna see that behavior shift.
• 12:59
  And when there's a real cultural transformation
• 13:01
  from is my block time, right, my precious,
• 13:04
  to a more team based approach and mindset
• 13:07
  is is operating in room time to serve
• 13:10
  the patients, not only one patient, all the
• 13:12
  patients. The mission of Inova, each each each
• 13:15
  patient, each time is touch every time.
• 13:19
  Then, actually,
• 13:20
  it changed when releasing time was viewed as
• 13:22
  helping colleagues and helping your patients across the
• 13:25
  system. Then all of a sudden, when one
• 13:27
  people once people understand the why, it's a
• 13:30
  lot easier to be part of that change
• 13:32
  instead of, instead of resisting it.
• 13:35
  And and that's really an evolution because so
• 13:37
  many surgeons, at least traditionally, viewed it as
• 13:40
  that's my time and that is sacred. And
• 13:42
  one of the reasons I operate at this
• 13:43
  hospital is that I get that time.
• 13:46
  And so having that giving the allowing them
• 13:49
  still to have some control of their schedule,
• 13:50
  their time, but finding ways to share that
• 13:53
  efficiently
• 13:54
  where it doesn't get in the way of
• 13:55
  how they do business, where they don't just
• 13:57
  glob out of that time, but they use
• 13:59
  it well. They're still really well taken care
• 14:01
  of your surgeons, but at the same time,
• 14:03
  you're opening up some room for cases and
• 14:05
  for people and viewing it more as a
• 14:06
  team game. Is that a fair statement?
• 14:09
  That's a fair statement. You're absolutely correct.
• 14:12
  Thank you. Talk about as you look forward,
• 14:15
  what do you see as the most compelling
• 14:17
  opportunities to build on what you've established with
• 14:19
  LeanTos, to build on what you've done with
• 14:21
  perioperative, and also just the the ORs in
• 14:23
  general? And and and what is getting this
• 14:25
  right
• 14:26
  look like as you continue to scale it?
• 14:28
  How many hospitals does Inova have now?
• 14:31
  Five hospitals. Five hospitals. One of the great
• 14:33
  midsize systems in the country. Really high operating,
• 14:35
  really high quality, just fantastic. So what does
• 14:38
  it look like to do this at scale
• 14:40
  across the Inova system,
• 14:41
  and what's the most compelling challenge next?
• 14:44
  So so I just wanna be clear that
• 14:46
  lean task is a is a system wide
• 14:48
  initiative. However, I I I see where you're
• 14:50
  coming from. I do believe that the biggest
• 14:52
  opportunity is continuing to scale this
• 14:55
  model across service lines,
• 14:57
  embedding data driven decision making to everyday operations.
• 15:02
  The getting it right at scales means aligning
• 15:04
  technology, leadership, and clinical engagement, so access becomes
• 15:08
  seamless,
• 15:09
  not something that surgeons have to fight for.
• 15:11
  Right? And, also, there's an opportunity to expand,
• 15:14
  and we use these insights not only for
• 15:17
  scheduling, but for broader perioperative optimization and system
• 15:21
  wide flow. From my perspective, personally, I think
• 15:23
  that success at scales means surgeons trusting the
• 15:27
  system,
• 15:28
  trusting,
• 15:29
  that we're gonna help to get the timely
• 15:31
  case patient care, and fully utilizing the resources
• 15:34
  that we already have.
• 15:36
  Right. But it it really is that that
• 15:38
  trust with surgeons and growth, trust and growth,
• 15:41
  and and and having them stay excited even
• 15:44
  as they change some of their patterns, but
• 15:46
  can constantly win that trust to know they're
• 15:47
  still gonna be really well taken care of
• 15:49
  and the patients could be really well taken
• 15:51
  care of as well as your teammates.
• 15:53
  Yeah. Exactly. And then I think that once
• 15:55
  you have that team mentality,
• 15:57
  nobody's here to play gotcha. We all want
• 16:00
  the same thing. Whatever hat or title or
• 16:04
  that you're wearing that day, we all want
• 16:06
  the same thing. We wanna serve the patient
• 16:07
  to the best of our ability.
• 16:10
  Thank you. Take a second. I'm gonna ask
• 16:11
  you another question in a second about final
• 16:13
  thoughts and so forth. Before I do that,
• 16:15
  one of our daughters
• 16:17
  just visited the country of Colombia.
• 16:19
  What is a place in Colombia that they
• 16:21
  can't miss, that they shouldn't have missed when
• 16:24
  they went there? What what's the most beautiful
• 16:26
  place?
• 16:27
  And and and and and she loved it.
• 16:29
  She said it was just fantastic. Her trip
• 16:30
  to Colombia. She was there for ten days.
• 16:32
  Tell us a little bit about what you
• 16:34
  can't miss in Colombia.
• 16:36
  So Cartagena is beautiful, and any anywhere that
• 16:39
  you're gonna read about Colombia, you're gonna read
• 16:41
  about Cartagena, you're gonna it's amazing, and and
• 16:43
  everybody that goes to Colombia should see it.
• 16:46
  It's very touristic. So if you're gonna go,
• 16:49
  take a boat and go to Rosario Islands,
• 16:51
  less touristic and also gorgeous.
• 16:54
  And I think for those of you that
• 16:56
  maybe are wanna do less touristic things and
• 16:59
  more cultural, the area of the coffee axis
• 17:02
  that includes Medellin
• 17:04
  is very safe right now and it's beautiful.
• 17:07
  And you have rivers that are, like, the
• 17:10
  seven colors of the of the rainbow. You
• 17:12
  have a lot of nature.
• 17:14
  I'm not sure people know this, but Colombia
• 17:16
  is the most biodiverse country in the world.
• 17:19
  And we have two oceans, and we have
• 17:21
  the Amazonic
• 17:22
  River below and the Orinoco River to the
• 17:24
  left. So,
• 17:26
  as you can tell, I love my country.
• 17:29
  So, yes. I would definitely recommend those two
• 17:32
  places for people that wanna travel. Well,
• 17:35
  fantastic. So it's I feel we've closed some
• 17:37
  of those loops on Columbia and also the
• 17:39
  University of Miami
• 17:40
  Med School as well as your fellowships and
• 17:42
  Harvard residency.
• 17:44
  Amazing, amazing career.
• 17:46
  What have you not talked about with the
• 17:48
  listeners? I mean, you you've gone on this
• 17:50
  great, great journey,
• 17:52
  with the Nova and WingTas, and they've had
• 17:54
  fantastic
• 17:55
  success with it. So congratulations on the work
• 17:58
  that you've done
• 17:59
  together to sort of really improve throughput
• 18:02
  and and improve culture and and and get
• 18:04
  just better data too. What have we not
• 18:06
  talked about? Is there anything else, doctor Farada,
• 18:09
  that we should share with the audience?
• 18:10
  Well, thank you, Scott. This is what I
• 18:12
  would say, and I will leave the listeners
• 18:15
  with this.
• 18:16
  Technology alone did not fix our problem. People
• 18:19
  that know how to use it did. All
• 18:20
  of us collaborating
• 18:22
  together
• 18:23
  is what changed the issue. Right? The tools
• 18:25
  gave us visibility, but what changed everything was
• 18:28
  trust. Trust between surgeons, which trusting the data,
• 18:32
  trust that this system was being designed for
• 18:34
  patients, not against clinicians. Right? There's a difference.
• 18:37
  That shift is harder than any implementation. And
• 18:40
  as I said before, I truly believe that
• 18:42
  culture is a strategy for breakfast. Our culture
• 18:44
  needs to be your strategy
• 18:46
  because it asks people to let go of
• 18:48
  control, to work differently with each other, to
• 18:51
  believe that collaboration will serve them better than
• 18:54
  protection, that that scarcity demands it. That only
• 18:57
  happens when leadership is consistent, transparent, and willing
• 19:01
  to stay in the work long enough for
• 19:03
  people to see the results.
• 19:05
  At the end of the day, this is
• 19:07
  not about operating rooms or block time. It's
• 19:09
  about access. It's about a patient waiting to
• 19:11
  have surgery or,
• 19:13
  a patient's they don't they don't care how
• 19:15
  your schedule is structured, really. They just care
• 19:17
  that they have appropriate safe surgery when they
• 19:20
  need it.
• 19:21
  So I think if we keep that, if
• 19:24
  we keep the patient,
• 19:25
  in the center as the north star of
• 19:27
  our decisions,
• 19:28
  everything becomes a little bit more clear.
• 19:30
  Technology is not your enemy.
• 19:32
  AI is not gonna replace you, but trust
• 19:35
  me, people that know how to manage AI
• 19:37
  will replace you if you don't learn it.
• 19:39
  I think we need to continue to use
• 19:41
  technology as an infrastructure, not not as an
• 19:44
  enemy or as a solution on its own
• 19:46
  either.
• 19:47
  To build system that people trust, not systems
• 19:50
  that only,
• 19:51
  uses slogans. Right? It has we have to
• 19:53
  live and breathe what we do and never
• 19:56
  lose sight in why these works matters. Because
• 19:58
  when we get it right, we not only
• 20:00
  improve efficiency,
• 20:01
  We give time back to our patients.
• 20:04
  I mean, it really is this great mix
• 20:06
  of culture, technology,
• 20:08
  leadership,
• 20:09
  you know, and what you're trying to accomplish.
• 20:11
  I mean, really, all those things. But but
• 20:13
  if if you don't have the culture right,
• 20:15
  people trying to learn and lean into what
• 20:16
  they're doing
• 20:17
  and retaining a great team and great leadership,
• 20:20
  nothing else works. I mean, you've gotta have
• 20:21
  that culture and the people part right, don't
• 20:23
  you? I a 100% agree. It's all it's
• 20:26
  all about people.
• 20:27
  And I think,
• 20:29
  and start seeing technology as a tool, like,
• 20:31
  be less afraid of
• 20:33
  it. Dive into it.
• 20:34
  A 100%. And I I love your point
• 20:36
  about leadership has to stick with it, not
• 20:38
  just for the idea phase, but actually through
• 20:40
  the implementation phase to get through the rocky
• 20:43
  parts and people start to see the benefits
• 20:44
  to it, then it can really start to
• 20:46
  work for the long run. I I I
• 20:47
  love that point as well.
• 20:49
  Awesome. Well, it's great to meet you, Scott.
• 20:52
  Doctor Firatta, a total pleasure. Thank you for
• 20:54
  joining us on the Becker's Healthcare podcast, and
• 20:56
  thank you to Lintas,
• 20:58
  for helping
• 20:59
  share doctor Frata with us today on this
• 21:01
  podcast. Just brilliant.
• 21:02
  Doctor Frata,
• 21:04
  chief of surgery at Inova Fairfax. Inova is
• 21:07
  one of the great systems in the country.
• 21:09
  Fantastic leadership. Thank you so much for joining
• 21:11
  us today. My pleasure.