Latest / Becker’s Healthcare Podcast / Building Better Decisions in Healthcare Leadership

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Building Better Decisions in Healthcare Leadership · Becker’s Healthcare Podcast

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  - The strategic agenda facing hospital and health system
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  - leaders right now is not a short list.
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  - Growth in a consolidating market, sustainable margins in
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  - a reimbursement environment that rarely moves in your
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  - favor,
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  - a tech investment cycle that demands both urgency
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  - and discipline,
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  - and a workforce story that is still being
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  - written.
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  - Eker's fourteenth annual CEO CFO roundtable brings together
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  - more than 1,500 executive level attendees and nearly
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  - 400 speakers across four days of sessions that
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  - are designed to help c suite leaders benchmark,
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  - pressure test, and sharpen their priorities.
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  - Not in the abstract, but against the real
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  - decisions they'll face heading into the next year.
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  - It's the kind of event you leave with
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  - a clear sense of where you stand and
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  - what comes next.
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  - So join us November second through the fifth
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  - at the Hyatt Regency in Chicago,
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  - and come ready to do the hard thinking.
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  - Register on our events page at beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
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  - This is Scott Becker with the Beckers Healthcare
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  - Podcast.
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  - I'm thrilled today to be joined by a
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  - remarkable leader. We're joined today by Brad Talbert.
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  - Brad is the CEO of Memorial Health University
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  - Medical Center in Savannah, Georgia.
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  - Savannah, for people that have not been there,
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  - is one of the most beautiful cities in
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  - the country and an amazing place.
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  - Brad also recently authored a new best selling
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  - book called Built to Decide.
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  - I've ordered it. I'll order another copy and
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  - just a fantastic leader in person.
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  - Brad, can you take a moment and tell
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  - us a little bit about your career,
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  - about Memorial Health University Medical Center, with this
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  - which is which is with, excuse me, ACA
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  - Healthcare. Tell us a bit about yourself and
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  - your career, then Then I wanna talk to
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  - you about some of the lessons in the
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  - book and and some of your your thoughts
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  - and and what drove you to write it
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  - and and a lot more. And and thank
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  - you so much for joining us. Well, Scott,
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  - it it's a pleasure to be with you.
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  - Thank you for everything,
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  - you guys do in the healthcare space, and
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  - really appreciate the opportunity today
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  - to
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  - talk about Memorial,
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  - and all the great things we're doing in
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  - Savannah,
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  - and then maybe a few leadership lessons
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  - for my new book. And I appreciate you
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  - calling that out. So, as you said, I'm
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  - Brad Talbert, CEO of Memorial Health University Medical
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  - Center in Savannah.
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  - We're a large
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  - system,
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  - Scott, seven eleven bed tertiary referral center
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  - with about 4,600
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  - colleagues and more than 800 physicians.
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  - We provide some of the highest acuity care
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  - in the region, level one trauma, comprehensive stroke,
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  - pediatric care through a children's hospital,
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  - and a 99 bed level four NICU,
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  - as designated by the state of Georgia. What
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  - really defines us,
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  - though, is our regional
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  - responsibility.
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  - When patients across Southeast Georgia need highly complex
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  - care, we're often the destination.
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  - That creates a tremendous sense of purpose,
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  - for our team. And so when
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  - when we think about responsibility,
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  - we think well beyond the four walls
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  - of our hospital.
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  - And so that's a little bit about Savannah,
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  - Memorial and, all that we do here.
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  - Thank you. And talk about sort of
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  - in Savannah,
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  - in in Georgia, the Southeast.
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  - What are some of the things you're watching
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  - in terms of health care trends currently?
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  - What what are the big things that you
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  - have your eye on? Is it
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  - labor? Is it physician shortages? Is it AI?
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  - Is it just taking care of people? Is
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  - it reimbursement? What are the big few issues
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  - that you're thinking about regularly?
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  - Yeah. So so I would really boil it
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  - down to three core areas, Scott. Health care
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  - economics,
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  - workforce,
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  - really work redesign,
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  - and then AI. So,
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  - within those three, health care economics,
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  - frankly, the cost and complexity to delivering care,
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  - continues to increase.
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  - Reimbursement isn't necessarily keeping pace, especially
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  - in a state like Georgia where Medicaid,
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  - was not expanded.
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  - We've recently seen significant impacts through the expiration
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  - of the enhanced premium tax credits at the
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  - end of twenty twenty five, other impacts through
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  - the one big beautiful bill. So we've seen
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  - a significant
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  - degradation,
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  - in covered lives in the state of Georgia,
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  - for example. I think we're seeing the same
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  - thing across the country in other,
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  - states, especially those that never,
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  - expanded Medicaid.
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  - So
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  - as you know, though, the bigger question is
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  - how we redesign the operating model while continuing
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  - to invest in quality, our people, and, of
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  - course, access.
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  - You can't cost cut your way to excellence.
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  - Right? So when we think about the second
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  - trend, workforce or or work redesign,
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  - gotta stop thinking about workforce solely as recruitment.
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  - We absolutely have to recruit and retain great
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  - people. There's no question about that. But the
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  - demographic suggests that isn't enough. So we have
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  - to think about recruitment plus retention plus redesign.
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  - So you think about top of license practice
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  - and how we're approaching that, simplifying
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  - workflows, automation,
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  - reducing administrative burden, new care delivery models,
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  - and technology that frankly gives caregivers
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  - time back. So healthcare can't recruit its way
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  - out of this workforce challenge. We have to
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  - redesign the work. And then kind of leading
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  - me to the third trend that I'm watching,
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  - which is AI.
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  - And, you know, AI really for us is
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  - not about predicting the future. We we're really
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  - thinking about how,
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  - AI is is practical utility now.
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  - So I'm less concerned in AI as a
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  - technology story, and I'm more interested in what
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  - it can actually do for our clinicians
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  - and our patients. So there's really three tests
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  - that we employ here.
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  - One, does it give clinicians time back? That's
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  - really important,
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  - to assess.
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  - Is it improving decision making or outcomes?
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  - And then three, is it removing friction,
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  - from our system?
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  - If AI simply becomes one more thing clinicians
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  - have to manage,
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  - I think we've missed the opportunity. So for
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  - for me to sum that up, the promise
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  - of AI isn't really more technology.
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  - It's giving people time and capacity back.
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  - Thank you. Let let me ask you a
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  - couple of questions.
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  - First, on the sort of movement of
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  - so quickly people not having coverage ahead of
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  - coverage before,
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  - what we're hearing across the country is that
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  - health systems, hospitals, practices
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  - are still seeing those patients, so the census
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  - aren't going down, but just not getting paid
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  - for them.
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  - Is there any bit of surprise at how
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  - quickly this has happened, the the sort of
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  - people losing coverage
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  - and yet, you know, obviously continue to see
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  - them, which is fantastic.
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  - But is there any sort of, like sometimes
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  - people predict that people lose coverage
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  - and it'll happen, but it happens very slowly.
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  - It seems like this time, it's happened quite
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  - quickly. People are seeing it pretty quickly. Is
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  - that a fair assessment?
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  - Yeah. That's that's exactly right. Certainly, in the
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  - in the market that that we serve, we've
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  - seen
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  - a fairly significant shift
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  - in insured,
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  - you know, health exchange
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  - covered lives to essentially,
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  - uninsured or or self pay.
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  - And so, you know, look. We've we've got
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  - a very robust approach to this. We we're
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  - we're kinda creating our own tailwinds. I mentioned
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  - some of those before,
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  - utilizing AI,
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  - redesigning
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  - work workflows.
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  - Financial resiliency
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  - is a big focus for us
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  - in
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  - our healthcare economic assessment.
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  - We're not gonna be able to cut our
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  - way
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  - to prosperity.
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  - We understand that.
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  - But,
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  - so there's tons of advocacy that we're still
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  - deploying to our elected officials,
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  - to our government
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  - agencies to help us really
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  - get the word out and help them rather
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  - understand
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  - the impact that some of these policy decisions
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  - are are making. We wanna arm our policy
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  - makers with the right information from, you know,
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  - from the field and from the ground level
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  - and hope that they will listen and understand
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  - the implications because you're right. I mean, it's
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  - almost been like a light switch has flipped
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  - off
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  - in in the last, you know, really since
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  - January.
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  - And we're seeing that impact,
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  - pretty
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  - pretty standard moving from
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  - health insurance exchange business to to an uptick
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  - in self pay.
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  - Thank you. And then in terms of artificial
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  - intelligence and AI,
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  - where are you seeing the most useful use
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  - cases so far?
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  - Yeah. For for us, again, I, you know,
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  - I kinda mentioned this. It's it's really,
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  - for us about,
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  - does it give clinicians time back? Does it
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  - improve decision making or outcomes? Does it remove
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  - friction from the system? So we think about
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  - HCA in our world here in Savannah,
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  - you know, we have a partnership with OpenAI,
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  - myself,
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  - my administrative
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  - colleagues,
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  - you know, our executives and leaders. We use,
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  - we use that technology each and every day
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  - to help us assess and analyze
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  - data.
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  - We're we're getting very good at utilizing
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  - AI to help us assess data to really
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  - get
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  - to the granular level, draw out trends, be
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  - able to take work product that would have
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  - really, in in in some cases,
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  - you know, lasted days and been able to
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  - drill that down into into a very short
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  - period of time to to compile that that
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  - sort of information and make really informed decisions
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  - that can help us address things quicker and
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  - faster. We're using AI in
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  - our scheduling technologies and and and really helping
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  - us to to deploy better work schedules, for
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  - example,
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  - with with our colleagues that that incorporate
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  - quite a bit
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  - of of AI technology. We're we have an
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  - Epic is our
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  - is our EMR. We we utilize many
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  - AI components of Epic to help us with,
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  - with with a number of things within the
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  - the EMR itself that that lead to better
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  - outcomes. So there's quite a bit
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  - that we're using. But again,
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  - it really is for us, and I'm sure
• 10:26
  - many listeners
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  - would say the same thing,
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  - it's really about
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  - less as a technology story and and more
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  - about what it can actually do for our
• 10:36
  - clinicians and patients.
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  - Thank you. And and and take a moment
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  - on your book, Built to Decide.
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  - Give us a couple of highlights on the
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  - thoughts on that, and also the sort of
• 10:46
  - the the origin story of of writing the
• 10:48
  - book and authoring the book.
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  - Well, so, you know, I I'm I'm often
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  - asked,
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  - about advice for evolving leaders. And so for
• 10:57
  - me,
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  - the the three three areas that that I
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  - I leave
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  - evolving leaders with is one, accept accountability.
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  - Leadership means accepting accountability for things that you
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  - don't completely control.
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  - You can always delegate responsibility, but you can
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  - never delegate accountability.
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  - So take ownership
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  - and accountability
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  - for for your work.
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  - Also, stay close to the work.
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  - As your responsibilities
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  - increase,
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  - there's a natural
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  - tendency to get further away from where the
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  - work actually happens. You need to fight that.
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  - Talk to nurses, talk to physicians, talk to
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  - techs, EDS workers, registration,
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  - patients,
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  - obviously.
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  - The higher up you go in an organization,
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  - the more intentional you have to be about
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  - staying connected to your reality. And the third
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  - piece is listening broadly and then decide.
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  - You wanna invite disagreement
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  - as a leader. Surround yourself with people who
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  - frankly will tell you when you're wrong,
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  - but eventually someone has to make the decision.
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  - And so people handle decisions they disagree with
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  - much better than they handle ambiguity and indecision.
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  - And that really was the crux behind,
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  - writing the book, Scott. My book, Built to
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  - Decide,
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  - is
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  - really, the core idea of that is that
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  - high performing organizations don't rely
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  - on a few great decision makers. They build
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  - systems that consistently produce good decisions.
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  - The goal really is just to clarify who
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  - owns a decision and get the right information
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  - to that person, make the decision at the
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  - appropriate level, and then learn from the outcome.
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  - Speed matters, but so does accountability.
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  - And leaders can create more value by building
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  - organizational decision capability
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  - than by personally
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  - making, you know, every important call.
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  - So that was really the, core idea behind
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  - Built to Decide.
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  - Thank you. And talk about that concept of
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  - because as
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  - people get further away from the work,
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  - often they become less effective in really understanding
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  - what drives organizations now that people are doing.
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  - I I love that thought process. Talk a
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  - little bit about that because that becomes harder
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  - and harder as you you know, I always
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  - found that the higher up I got,
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  - the more profitable it was and the less
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  - satisfying it was. And and and what I
• 13:13
  - mean by that is is sometimes you make
• 13:15
  - more money as you get to be more
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  - senior, but certainly the enjoyment of really being
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  - close to people and really being close to
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  - who you're serving gets a little bit further
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  - away. And I've always found it to be
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  - this disconnect
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  - between sometimes,
• 13:29
  - and I think you you say it really
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  - well. You have to fight that because the
• 13:32
  - closer you stay to those actually engage
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  - the actual patient, the actual whatever you're serving,
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  - the more satisfying it is.
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  - Any any thoughts there, Brad? Because I I
• 13:42
  - I resonate that line of thought that you
• 13:44
  - have there residential would be so much, and
• 13:47
  - I think it's so true. And I think
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  - we're so much more effective when we stay
• 13:49
  - closer to it. And it's more satisfying too.
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  - Yeah. So for me, it's the best part
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  - of my job. And and you have to
• 13:56
  - be intentional,
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  - as I said earlier, because your day can
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  - get away from you, and, there's this, you
• 14:02
  - know, Zoom call or that meeting or you
• 14:05
  - know? And there's always competition for for the
• 14:08
  - time to say, I'm just getting out of
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  - the office. I'm going to a nursing unit
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  - or I'm going to the ER or I'm
• 14:14
  - gonna go around on patients in ambulatory surgery
• 14:16
  - and and just connect. Right? And and that's
• 14:19
  - where I've found not only do I make
• 14:21
  - the most impact
• 14:23
  - to the organization, but I also
• 14:25
  - feel the most impact. And it, it rewards
• 14:29
  - me and reminds me of of why we
• 14:31
  - do what we do. I mean, it's one
• 14:33
  - thing to say it,
• 14:35
  - but but when you're able to look a
• 14:37
  - patient and a family, you know, in the
• 14:39
  - eyes and and look staff members in the
• 14:41
  - eyes and and hear from them directly about
• 14:43
  - their experience and and then take that information
• 14:47
  - and maybe shape things to to to improve
• 14:50
  - upon that or take the positives
• 14:52
  - from the family that had a great experience,
• 14:55
  - and then you share that with those caregivers,
• 14:57
  - and physicians and and team members,
• 14:59
  - and you celebrate those folks and and you
• 15:02
  - reinforce, hey. We wanna do this more, more
• 15:05
  - and more. It it it obviously is incredibly
• 15:07
  - rewarding. And I know many folks that that
• 15:09
  - listen to your podcast probably do the same
• 15:11
  - thing each and every day. But for me,
• 15:13
  - you know, if you kinda
• 15:15
  - bring it back to to
• 15:17
  - a a core component of of the book,
• 15:19
  - the book necessarily isn't about staying close to
• 15:22
  - the work, but it is about driving decision
• 15:24
  - making capability,
• 15:26
  - across the organization.
• 15:28
  - So, you know,
• 15:29
  - great organizations deliberately design how decisions get made,
• 15:34
  - and you wanna put decisions close to the
• 15:36
  - information. So the person with the best knowledge
• 15:38
  - should often have more authority, not simply the
• 15:41
  - person with the highest title. So I'm probably
• 15:43
  - not as the CEO of a very large,
• 15:47
  - you know, level one trauma center. I may
• 15:49
  - not be the best to be making some
• 15:51
  - of those,
• 15:52
  - day to day decisions on our trauma ICU.
• 15:54
  - We've gotta empower, for example, we've gotta empower
• 15:57
  - our nurse managers and our nurse directors,
• 16:00
  - and our physicians to be able to make
• 16:02
  - those decisions and support those. You know, clarify
• 16:04
  - decision rights, separate who decides, who provides input,
• 16:08
  - and who is ultimately responsible for the execution.
• 16:11
  - But, that to me is, is the biggest
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  - opportunity,
• 16:16
  - that I think we have, especially in a
• 16:17
  - large organization where there's so many layers.
• 16:21
  - No. I I love that. And I think
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  - empowering the right people and then staying accountable
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  - as a leader is so so important. I've
• 16:27
  - ordered the book. I'm looking forward to reading
• 16:29
  - it. Brad, I wanna thank you so much
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  - for joining us today on the Becker's Healthcare
• 16:32
  - Podcast. Remarkable leadership, remarkable system. Thank you so
• 16:36
  - much for taking the time with us today.
• 16:38
  - Thanks, Scott. Appreciate you.