Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Marjorie Bessel, Chief Clinical Officer at Banner Health

Transcript

Dr. Marjorie Bessel, Chief Clinical Officer at Banner Health · Becker’s Healthcare - Clinical Leadership Podcast

0:00
Hi, everyone. Thank you so much for tuning
0:02
in to the Becker's Health Care podcast.
0:05
I'm Erica Carbajal, an editor with Becker's Hospital
0:08
Review. And I'm so honored today to be
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joined by doctor Marjorie Bessel, who is the
0:13
chief clinical officer at Banner Health. Doctor Bessel,
0:17
thank you so much for taking the time
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to be on today.
0:19
It's my pleasure. Thank you for having me.
0:22
Yeah. A lots to talk about today. Lots
0:24
going on.
0:26
Before we get into it, do you mind
0:27
just sharing a little bit about the scope
0:29
of your work at Banner Health and how
0:32
long you've been there?
0:34
Absolutely. So,
0:35
I'm chief clinical officer for Banner Health and
0:38
have responsibility
0:40
for quite a number of activities within the
0:42
organization, but, of course, first and foremost is
0:45
the quality and safety of the care that
0:47
we deliver.
0:48
I also oversee a number of other areas,
0:51
including security,
0:53
performance improvement,
0:56
deep connection to our health plan through our
0:58
chief medical officers,
1:00
and enjoy every moment of my work.
1:03
I've been with Banner,
1:05
in my current role now, for eighteen years
1:08
with the organization and seven in my current
1:10
role, and it has been just a wonderful
1:12
organization to have a career of a lifetime
1:14
with.
1:16
Oh, eighteen years. Congrats on that, doctor Fussell.
1:20
Well, I'll get right into it. I know
1:22
Banner Health has achieved
1:24
impressive results under your tenure.
1:27
One of more recent ones, significant reductions in
1:29
length of stay, which is a huge,
1:32
area of focus for many health systems that
1:34
that led to nearly 28,000,000
1:36
in savings in 2023.
1:39
So can you take us behind these wins
1:42
and shed some light on on any key
1:43
strategies,
1:44
cultural shifts that helped drive the success, and
1:48
any lessons that other systems
1:50
might take away to drive similar improvements as
1:52
they really hone in on length of stay?
1:55
Absolutely, Erica. And thank you so much for
1:57
that. So first of all, kudos to our
1:59
team,
2:00
that worked together to deliver those results. We
2:03
have impressive results for 2024
2:05
also that we're still tabulating, but,
2:07
exceeded our goals on length of stay.
2:10
But as many of our listeners probably know,
2:13
length of stay is really a very significant
2:16
roll up measure
2:17
about everything that you do, how your entire
2:20
organization is functioning.
2:21
It includes everything from, like, your prehospital care,
2:25
the ED, which remains the front door to
2:27
most all of our hospitals,
2:29
the in hospital care and coordination, and then,
2:31
of course, providing with the needs of the
2:33
patient in the post discharge
2:35
arenas, whether that is going home with services,
2:38
going home without services, or needing to go
2:40
to another level of care for post discharge.
2:43
As you'll hear probably from myself, a number
2:46
of times here today and any of the
2:48
rest of us who are executives at Banner
2:49
Health, we have a very significant strategic approach
2:52
to everything, which is a one team approach.
2:56
As length of stay, that includes engaging everybody
2:59
across all those different areas that we spoke
3:01
about and doing work in all of those
3:04
areas. It takes a lot to move this
3:06
boulder of length of stay, and there is
3:08
a tipping point where you've got a lot
3:10
of items finally moving in a direction to
3:12
really start to see that length of stay
3:14
drop.
3:15
I love length of stay because it's a
3:17
coming together
3:18
of clinic
3:20
and operations
3:21
with a single focus of taking great care
3:23
of patients when we take great care of
3:25
patients and we don't have safety events. And
3:28
the quality of the care that we deliver
3:30
is really awesome, and we do a lot
3:32
of coordination,
3:33
that is when you see great length of
3:35
stay. It's great for the organization. It allows
3:38
us to have that bed open up to
3:39
take care of another patient who needs us
3:41
in our community.
3:42
It's also great for the patient right in
3:44
front of you who goes home on the
3:45
day that they expected
3:47
with a care plan that has been
3:49
executed and delivered to them and their their
3:52
caregiving team in a way that they expected.
3:55
So my
3:56
tip for, I guess, everybody out there is
3:58
to avoid looking for, like, the single lever
4:01
to improve this very roll up measure. Make
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sure you're engaging with everybody like we do
4:05
with a one team approach,
4:07
nursing, your post acute providers that you probably
4:10
do not own and work collaboratively will with
4:12
your primary care physicians, your specialists,
4:15
and even those responsible for turnaround time of
4:18
your beds, think EVS.
4:20
They all play a big role as do
4:22
the hospitalists that are delivering the care each
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and every day.
4:26
Yeah. Doctor Bessel, such great points just throughout
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how,
4:30
you know, it really entails a strategic approach
4:33
across all those areas and teams, you know,
4:35
not just the front end, not just the
4:37
care coordination, not just one initiative, but really,
4:41
working in tandem to drive those ex improvements
4:44
and excited to hear more about the advancements
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that that you mentioned for 2024
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that are coming
4:50
through.
4:51
Doctor Bessel, on this,
4:53
you know, same topic, just kind of around
4:56
improving access and capacity,
4:58
it really is something that in almost every
5:01
conversation we have with health system leaders today
5:04
that comes up as an area of focus.
5:06
But at the same time, many acknowledge that
5:09
the cost of funding new efforts, whether that
5:11
be for certain technology or capital,
5:14
investments, expansions,
5:16
can be a barrier or challenge to improve
5:19
throughput.
5:20
So can you share a little bit about
5:22
this? How is Banner tackling
5:24
these challenges in the year ahead, and where
5:26
is the health system really focusing resources to
5:29
try to balance
5:31
cost and impact with capacity?
5:34
You know, Erica, thank you for asking that
5:36
question. It's such an important one, and I
5:38
know that for our listeners, it's one that
5:40
everybody is thinking about working on and very
5:43
focused on.
5:44
From a Banner Health perspective, again, I wanna
5:47
bring that strategic pillar in of the one
5:49
team approach to this.
5:51
Again, this is something that requires many of
5:54
our different parts of our organization coming together
5:57
and working together in order to move the
5:59
dial on this.
6:01
Another thing I'd like to call attention to
6:03
that's for our organization is that our mission
6:06
statement
6:07
is very consumer focused.
6:09
Making health care easier so life can be
6:12
better.
6:12
We know that health care made easier
6:15
is a tough calling and access is a
6:18
big piece of that. So here at Banner
6:20
Health, through our one team approach, we are
6:23
making investments in technology
6:25
that signify a commitment to our mission.
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So that means both for patients and for
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clinicians.
6:32
Making health care easier for our clinicians to
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deliver so that their professional
6:37
life and journey and career can be better
6:40
with us here at Banner Health.
6:42
A big piece of this is how can
6:44
we help reduce the burden of what it
6:46
takes for a clinician to deliver care. So
6:49
investments in AI technology, specifically around ambient listening,
6:53
is a big one for clinicians.
6:55
One of my absolute deliverables in the next
6:58
five years is to reduce the administrative
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burden for clinicians by 50%.
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That is a huge audacious goal, and yet
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I feel that when you have me back
7:09
in five years, I'm gonna tell you that
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we got it done together here at Banner
7:12
Health. And it's gonna be through these AI
7:14
and technology investments
7:16
that make the day and the life of
7:18
the clinician better, helps make them more efficient
7:21
so that access is opened up to those
7:23
patients that need need us. As I think
7:25
we're all discovering,
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AI technology has a lot of different flavors
7:29
out there, but when you're really focused on
7:31
trying to reduce that administrative burden,
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it not only helps the clinician, but it
7:37
enables a better visit for the patient.
7:39
There's of course more efficiency for the physicians
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and and every other provider and that then
7:44
of course opens up access for patients. So
7:47
more to come on that, like many of
7:48
us, in the industry, we're relatively still learning
7:52
about ambient listening and these
7:55
other technologies to deliver everything that I spoke
7:57
about, but it's moving really quickly. And I
7:59
think we will all see really significant deliverables
8:02
that happen and get all the way across
8:04
the finish line in 2025.
8:07
Yeah. Some huge goals there, that 50%. It's
8:10
so interesting. Do you have that broken down?
8:12
I know you said over five years. You
8:13
have that broken down sort of into,
8:16
you know, more tangible goals year by year.
8:19
Is that sort of how do you've organized
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that one?
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So, you know, the interesting thing about that
8:24
big audacious goal is we don't know exactly
8:27
how we're gonna get there yet, but we
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do have some really tangible goals as technology
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becomes available.
8:33
I firmly believe that as we, you know,
8:35
just spoke about a little bit ago, that
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ambient listening is a huge piece of that
8:40
50% burden, and that field is changing really
8:43
quickly.
8:44
I expect that within the next eighteen months,
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every single one of our physicians here at
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Banner Health will have an ambient listening tool
8:51
that is really fine tuned for their specialty
8:54
and the way they deliver care at their
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fingertips and being really utilized that will open
8:58
up that access for patients to get to
9:00
in to see them more quickly.
9:03
Yeah. For sure. So much,
9:05
optimism around these tools. I I was speaking
9:07
with another leader recently, physician leader who who,
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you know, said hesitant to call things game
9:13
changers in health care and and use that
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term sparsely, but, really,
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no hesitation
9:19
when it comes to using that to describe
9:21
ambient listening and just based on what physicians
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are saying through pilots and saying, you know,
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we really can't imagine going back to not
9:29
having this. So,
9:31
sort of the cat is out of the
9:32
bag there. It it's just so interesting to
9:34
hear
9:35
how big of a role it really plays
9:37
in freeing them up and then that that
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how that translates into,
9:41
additional capacity and freeing things up.
9:44
I completely agree, and I think game changer.
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I will commit to that term for this
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one.
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Our pilots are exactly as you described, and
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you know that you've had a game changer
9:53
when people are begging you to not take
9:55
the tool away.
9:57
Yeah. Absolutely.
10:00
Doctor Bessel, I wanted to ask you as
10:02
well just about something that comes up frequently,
10:05
a challenge in conversations with physician executives,
10:09
and that is just around engaging younger health
10:11
care workers in leadership.
10:13
Is that something that resonates with you? And
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if so, what has been effective in encouraging
10:19
people to explore their own leadership potential and
10:22
not shy away from it off the bat.
10:25
Another really awesome and important topic. So, certainly,
10:29
preparing future decades of the workforce is a
10:31
very important aspect
10:33
for anybody who's an executive in health care
10:35
right now. Here at Banner Health, we are
10:38
really deeply embedded in our communities, and we
10:40
have a number of strategies that we work
10:42
with to make sure that young students, first
10:45
of all, are going to enter in health
10:46
care. And then, of course, once they're in
10:48
health care, it's very important to show all
10:50
of our team members how there is a
10:52
journey of a lifetime available for them with
10:54
us So that, of course, includes physician leadership
10:58
Here at Banner, we've built a really nice
11:00
portfolio of offerings to develop skills for these
11:03
types of individuals
11:04
As we all know, skills like these are
11:06
valuable in many other parts of our life
11:06
It helps us be better with our families,
11:06
it helps us
11:10
families. It helps us be better with our
11:12
patients and our day to day clinical teams.
11:15
I've been lucky because I've been here, in
11:18
developing these for over ten years now. And
11:20
I think it's really important
11:22
for physicians to see that they don't always
11:24
get these skills in their formalized training. And
11:27
here at Banner and other organizations, we recognize
11:30
that we need to really engage with them
11:32
to help them work on them.
11:34
Here at Banner Health, it culminates with a
11:36
course that we call ALP, which is advanced
11:38
leadership course for physicians in APP.
11:41
And I'm happy to say that we just
11:43
graduated our eighteenth cohort
11:45
of that. I think what we hear most
11:48
about those that have finished this is the
11:50
personal stories
11:51
that resonate
11:52
with them from leaders in our organization.
11:55
Many of us, myself included,
11:58
don't start with a really crisp road map
12:00
of, hey. I'm starting as a bedside clinician,
12:02
and I wanna be x. Chief clinical officer,
12:05
chief medical officer, physician executive, you fill in
12:08
the role.
12:09
So it's really important that we capitalize on
12:13
those stories and let people know, hey. You're
12:15
going to be on a journey.
12:17
You need to work with others, and you
12:19
need to trust others who see potential in
12:21
you and ask you to do things like
12:25
take on a new project and say yes
12:27
to that. Again, kinda Erica, going back to
12:30
our one team approach here at Banner Health,
12:32
I think that has been a secret sauce
12:34
of success.
12:35
Our guest speakers at these programs, of course,
12:38
they're not just physicians. They're executives from across
12:40
our large organization,
12:42
and I think that helps show everyone how
12:44
we're really committed to that collaboration for the
12:47
development of those physician leaders.
12:50
Yeah. That's great. What a great program.
12:52
Great to hear that eighteenth cohort has gone
12:54
through that and is finding value in that.
12:58
Doctor Bessel, on the topic too of physician
13:01
workforce shortages,
13:03
obviously, a huge area of coverage and a
13:06
major concern across health care.
13:08
What do you think is missing from conversations
13:11
about this issue? Are there any overlooked factors,
13:14
perspectives that you call out, that health systems
13:18
might be
13:19
or should be paying more attention to?
13:22
So I I'm not sure that there are
13:24
things that are per se, you know, overlooked.
13:27
Again, I think these shortages are complex. They're
13:30
multi pronged and therefore need a very multidisciplinary
13:34
approach.
13:35
I'll highlight a couple things that are very
13:37
important here at Banner Health that may resonate
13:40
with some of our leaders. So first of
13:42
all,
13:43
Banner Health is coming up on our ten
13:44
year anniversary of our relationship with the University
13:47
of Arizona,
13:49
which is the state's largest academic medicine program.
13:53
A big statistic that we're very proud of
13:54
is that we train more than 1,300 residents
13:57
and fellows and 5,000 nurses rotate through Banner
14:00
every
14:01
year. This relationship with our academic partner is
14:04
a big piece and a huge important part
14:07
of trying to address those workforce shortages of
14:10
the future and really working together to support
14:13
our communities so that we're there for them
14:15
and can provide care.
14:17
Another piece I'd like to talk about is
14:19
the promotion of well-being.
14:21
We know that well-being and the reduction of
14:24
burnout is an important piece of addressing workforce
14:27
shortages.
14:28
We've all seen the aftereffect of the stress
14:30
and strain of the pandemic
14:32
and what that did to our workforce.
14:35
We've been very committed to that work across
14:37
our organization,
14:39
have been
14:40
really exquisite about measuring our impact, and I'm
14:43
happy to report had great success in 2024
14:46
with the lowest rate of self reported burnout
14:49
since we started exquisitely measuring that in 2018.
14:53
Another piece of that, like we already talked
14:55
about, Erica, is making sure that you're investing
14:57
in technology and the right technology
15:00
that can help make your workforce very efficient.
15:03
And lastly, do you wanna talk about making
15:06
sure that you have your physicians and your
15:08
clinicians
15:08
at the table for decision making.
15:11
I think we all have recognized
15:13
the stress and strain of being in the
15:15
industry and how that really gets accentuated
15:18
when physicians and other clinicians feel like they
15:20
don't have a voice at the table where
15:23
decisions are being made, where they feel like
15:25
they lose their autonomy.
15:27
And that, of course, leads to a lot
15:29
of potential
15:30
departures and general disgruntlement about being in the
15:33
industry.
15:34
As we spoke about technology, ambient listening is
15:37
a big piece of that and constantly looking,
15:40
and my five year goal of reducing that
15:42
administrative burden, I think, needs to be at
15:44
the forefront for all of us. That will
15:46
help us mitigate
15:48
these workforce shortages in the future by making
15:51
sure that we're making our workforce as engaged,
15:54
as productive,
15:56
and as happy as possible
15:58
at work each and every day.
16:01
Oh, yeah. The
16:03
great success with,
16:05
lowering that self reported burnout rate. I think
16:08
it's such a big win,
16:10
because I know we've seen some of the
16:11
national numbers, and trends haven't moved too too
16:14
much, you know, from 2021, '20 '20 '2,
16:17
etcetera. So,
16:19
just great to to hear about that and
16:20
just all the ways that those technology investments
16:23
and that really unburdening
16:25
physicians and focus there is showing results and
16:29
and having a strong impact.
16:32
Doctor Bessel, to close us out, can you
16:34
share a piece of advice for emerging clinical
16:37
executives in health care? Is there a memorable
16:40
piece of advice you've received at some point
16:42
in your career that's helped shape your leadership
16:45
style that still shows up today?
16:48
Yeah. Such a great question and what a
16:50
great one, to close out.
16:53
So my best piece of advice that I
16:55
would give to others and one that was
16:57
offered to me really early in my career
16:59
that I think was incredibly helpful
17:02
was making sure that you are open to
17:04
trying different experiences.
17:07
Simple to say, hard to do.
17:10
But what comes along with that is that
17:12
when you really listen to others, when they
17:15
perhaps give you an opportunity,
17:17
sometimes we don't even recognize that it's an
17:20
opportunity.
17:21
So something like, hey, do you mind standing
17:23
in for me at this meeting? Do you
17:25
mind taking on this short project that has
17:27
two meetings?
17:28
It can be something as small as that.
17:31
But I think saying yes to those experiences
17:33
is so incredibly helpful for growth. And what
17:37
sits behind that, which I think is a
17:40
really important takeaway from this conversation,
17:43
is that the person
17:44
asking you to potentially do something different as
17:47
an experience
17:48
is seeing something in you that perhaps you
17:50
don't recognize yourself.
17:52
So when somebody asks you to do that
17:54
extra
17:56
thing, try and think of it as both
17:57
a yes as well as, like,
17:59
that person must see something in me. Let
18:01
me find out more about that. Go do
18:04
this project and do a follow-up to find
18:05
out what else I can work on for
18:07
my future.
18:08
It was really helpful for me in my
18:10
career, and I hope it's helpful for our
18:11
listeners.
18:13
Yeah. What a great way to close out.
18:15
Doctor Bessel, thank you so much. It's been
18:17
a pleasure having you on today, and I'm
18:20
sure
18:20
listeners will just find this conversation
18:23
so valuable. We talked about so many big
18:26
pressing trends affecting health care operations,
18:29
from patient throughput, physician satisfaction, etcetera. So so
18:32
appreciate your insights.
18:34
So wonderful to be with you, and I
18:36
hope our listeners enjoy
18:37
our conversation as well.
18:39
For sure. Look forward to connecting again.