Latest / Becker’s Healthcare Podcast / Standardizing Care and Expanding Specialty Services at Cleveland Clinic Martin Health

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Standardizing Care and Expanding Specialty Services at Cleveland Clinic Martin Health · Becker’s Healthcare Podcast

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Hi, everyone. You're listening to the Becker's healthcare
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podcast.
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I'm Erica Carbajal with the Becker's hospital review
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team. For today's episode, we're joined by doctor
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Chidag Choudhary,
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vice president and chief medical officer of Cleveland
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Clinic,
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Martin
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Health. Doctor Chowdhury, thank you so much. Welcome
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to the podcast.
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Oh, thank you for having me. I'm delighted.
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Yeah.
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Well, to start us off, what is the
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single most important goal that you'd point to
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that you're focused on in your first year
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as CMO of Cleveland Clinic Martin Health? I
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know you joined recently.
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Yeah. Absolutely.
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So just a little bit of background.
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At Cleveland
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Clinic Martin Health is a three hospital system,
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that includes,
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Martin Cleveland Clinic Martin North, Martin South, and
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Cleveland Clinic Tradition Hospital.
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I was lucky enough
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to serve in the role of vice president
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chief medical officer of Cleveland Clinic Tradition and
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now in this expanded role over all three
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hospitals within the within the Martin Health System.
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What that allowed me to do is, one,
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get a good understanding
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of
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how the hospitals are functioning and how they're
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interconnected
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with each other.
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And because at the end of the day,
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what we wanna provide is a strong foundation
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of clinical care,
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and we wanna be able to deliver this
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consistently,
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reliably,
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across both counties that we serve, which is,
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Martin County and St. Lucie County.
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Now what does that mean
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for somebody who does not work in medicine
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who who who might listen to this? What
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that means is if someone comes in as
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a patient,
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where it doesn't matter as to which facility
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that they walk into, whether it's the hospital,
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whether it's one of our outpatient sites,
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that they experience the same safe,
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timely,
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and coordinated care every single time. What we
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want them to that experience needs to be
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absolutely standard irrespective whether it's outpatient,
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inpatient,
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and it doesn't matter as to which site
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they they interact with us.
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Looking
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into
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how do we go about
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making this happen,
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and everything starts with data.
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We look at our capacity. We see as
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to how we're using it,
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quality and safety outcomes across the board,
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and then what our communities are asking off
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us, whether it's the hospitals or the ambulatory
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sites.
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Where is the demand?
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What,
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so which services do the patients need?
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And if there is any variation in the
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care that we are providing across these sites
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and how do we meet those needs?
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When we start after starting with data, our
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next piece is working with our
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team of teams.
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It's our physician leaders, it's our nursing leaders,
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our operations leaders, both on the inpatient side
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and the ambulatory teams,
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fully coming up with some concrete priorities.
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Things like standardizing
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our key clinical pathways,
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making sure access is streamlined,
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and then sequencing what our capital and program
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investments are going to be
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so that we're not just reacting to the
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current volume and the current demand,
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but what does a community need
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right now and what will it need for
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the next five, ten, fifteen, twenty years into
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the future.
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So we've started with data. We've got our
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teams together. We have a plan. We
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on the capital capital plan, be able to
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meet the needs.
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And then
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there comes the next step.
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How how are we doing with our our
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plan?
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And a few early markers of that are
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really around
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targeted quality metrics.
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Were we able to onboard the new specialists
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and the new primary care doctors that we
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wanted to wanted to start at these sites?
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And how are we coordinating?
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Because you know care is getting more and
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more complex especially in
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the state of Florida where Cleveland Clinic Martin
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Health is.
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We have an older patient population,
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people with very complex needs.
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How are we being able to meet these
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complex
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care requirements,
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not just at that one site of interaction
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at one of our ambulatory sites,
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but
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being able to act make sure that these
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patients are able to not only meet their
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primary care needs, but any of their consultative
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needs at any
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of our other ambulatory locations or if testing
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needs to happen on the inpatient side.
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So overall, I would say looking back at
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this first year of serving in this role
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over
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the three hospitals,
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I think we have really raised the bar
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when it comes
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to reliability.
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We have planned for some very thoughtful growth
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and made real progress.
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Yeah. Thanks for sharing that. I think it's
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it's always interesting to hear just about the
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theme of, you know, consistency
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in in the care experience and in care
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delivery
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and, you know, so much that goes into
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that in terms of clinician alignment
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and analyzing the data,
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so much strategy and planning. So interesting to
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hear about. Thank you for sharing.
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I know you mentioned your previous role as
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CMO at Tradition Hospital, and there, I know
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you helped expand
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key programs like the comprehensive stroke center and
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helped recruit specialists to strengthen cardiovascular
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and specialty services.
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One of the things that we hear a
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lot about is the competition for specialists, especially
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sub specialists. So as that intensifies
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nationwide,
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what strategies have you found most effective in
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attracting and retaining the talent that is actually
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needed to build and sustain
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those types of programs?
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Absolutely. That's a that's a great question
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and very timely to
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if I was to look back at
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my week this week,
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we have I've sat down and interviewed
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two possible,
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cardiologists
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that we would like to to join our
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team.
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And before I ask them to, you know,
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you know, we looked at the CVs before
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I ask them, like, please tell me about
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yourself.
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The first question I ask is, what do
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you wanna know from me? And they that
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the
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every single time the question is, well, what
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is your vision?
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And that is
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where
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I feel like what separates us and being
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and end up being able to recruit the
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the the top talent that we need is
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being able to articulate as to what our
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community needs,
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where the demand is growing,
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how they're going to come help not only
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expand the program, but really build the program
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and be able to take it to the
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next level. And it doesn't really matter whether
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it's cardiovascular care, stroke care, or any other
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complex service.
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It's not as it's not simply filling
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a vacancy.
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That role is far more compelling
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for the physician
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when they can see how they're contributing,
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and
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it it also ensures that we're doing the
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right thing for the communities that we serve.
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And at the same time,
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recruitment
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is
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fundamentally
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relational.
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We want to get to know as to
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what their professional goals are,
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what the family needs, what kind of culture
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are they looking for,
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and
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does that align with Martin Health and Cleveland
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Clinic?
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Because we want them to come, we want
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them to stay, we want them to be
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happy, their their families to be happy,
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because that's the only way we're gonna be
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able to deliver on our commitment to quality
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and and and safety.
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In addition to that,
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what
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what allows us to be able to really
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recruit this top talent is
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just the breadth and the scope of Cleveland
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Clinic
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because it allows people's careers to evolve.
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There are different leadership opportunities, whether it might
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come in academia,
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research,
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publishing,
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on an operational end, and then getting involved
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in any any any quality program.
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So it allows people to evolve not only
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as
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clinicians,
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but but but the person as a whole
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and really, like, add to,
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what what they what they're looking for depending
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on whichever
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chapter that they they are in their lives.
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Another place that gets overlooked sometimes is
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when a new physician or a new surgeon
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starts,
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how do they feel
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when it comes to support?
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What I'm what I mean by support is
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do they have the appropriate nursing support?
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Operationally, are things working that they the the
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way that they should?
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Are are ambulatory teams making sure that the
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referral patterns are set up, the support staff
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is there, and that there's a good
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onboarding plan.
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We want our doctors to and our clinicians
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to feel
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supported
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and productive from day one.
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We don't want someone to come and then
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try and spend the first six months trying
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to figure out how to how to navigate
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the system.
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And I can give you another very concrete
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example, you know, focusing on the cardiology piece
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is
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we're recruiting cardiologists.
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We have recruited our, you know, we've really
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grown our neurology, neurosurgery, neuro interventional program.
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And it's not just to meet the broader
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growing cardiovascular and complex care demands of this
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region,
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But it's really making sure that when we
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are meeting these needs,
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we are also ensuring that our patients receive
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the most advanced care
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close to home. They never have to get
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into a car and have to drive by
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the Orlando or Miami to get this care.
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That we are going to be able to
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provide this care to them here at home
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within their communities
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locally
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on the Treasure Coast.
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So it's a very
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intentional
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program focused on finding the right cultural fit
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and having our, physicians, our surgeons, our clinicians,
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our nurse practitioners, our peers, anyone who joins
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really feel that their work is impactful
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and that we're committed to committed to them.
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Yeah. Doctor Chaudhry, and I think you raise
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a great point too that we don't often
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hear a ton about just, you know, when
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it comes to
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discussions around
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recruitment is that the piece of
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having painting the the picture for physicians and
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having them see their involvement
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in in decision making and kind of the
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bigger picture
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and painting that for what that looks like
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for them and how valuable that that can
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be.
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I know earlier in our discussion, you mentioned
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just, you know, demands for care growing and
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care becoming more complex. I think especially acute
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in Florida, where can the state continues to
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see such population growth, especially among older adults.
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So can you expand a little bit on
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how Martin Health is thinking about
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which specialty services to expand locally versus when
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to leverage Cleveland Clinic's broader Florida or system
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wide network?
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Yeah. Absolutely. I think this is what helps,
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for us to be a part of a
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large
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global academic health system
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is needs that we can meet locally
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and then what we can lean on on
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our worldwide expertise,
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for
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specialties that we might may not have currently
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or or have,
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and and being able to make sure that
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our patients have access to them.
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So focusing on Florida,
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Florida
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in general
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and the Treasure Coast in particular,
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specifically the St. Lucie County area
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has really experienced some very rapid population growth.
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It has become incredibly popular,
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during and post the the COVID pandemic.
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And as you know, it's
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generally an older population,
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multiple chronic conditions,
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and the need to be able to provide
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complex
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care I mean, care for complex clinical conditions
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in a very coordinated manner.
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First step for us, again, you know, going
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back to,
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the the first question is around understanding
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data.
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Where are the people moving to? Which neighborhoods
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are growing?
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What conditions
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are do people need the services for?
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And which services are patients currently having to
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travel to receive that we can
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meet these needs locally.
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After that, we ask ourselves two key questions.
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Where is it essential to build this local
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capacity
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so our patients can receive
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timely, high quality care that's
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close to home?
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And where do where is it better for
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us to tap into the breadth of the
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Cleveland Clinic network, whether it's in Florida at
13:10
Western
13:11
or across the enterprise,
13:13
in in in Cleveland, Ohio
13:15
for this highly specialized
13:18
coronary services.
13:20
So in some areas like emergency care, stroke
13:23
care, cardiovascular services,
13:25
medical services, general surgical services,
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we offer these robust local capabilities right here
13:31
on the Treasure Coast at Tradition,
13:34
Martin North, and Martin South,
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which means, you know, investing in the right
13:40
specialist, the right technology, the right care models,
13:44
really make you know, really leveraging our our
13:46
nurse practitioners, our physician assistants,
13:49
with the with the physicians and surgeons
13:51
so that our patients don't face any delays
13:54
when it comes to accessing care, especially in
13:57
sensitive situations
13:59
and making sure that they stay
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connected
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with their
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local
14:05
healthcare team and their local communities.
14:08
In other areas where it makes our sense
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to leverage our broader network,
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that's where we coordinate referrals, whether it is
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with our other Cleveland Clinic Florida location in
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in in Western.
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It could be in person or it could
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be through virtual consults with sub specialists
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and
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arranging seamless transfers for highly complex procedures where
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a patient might
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travel to have a specific complex procedure done
14:36
at Western, but we can do all the
14:38
pre
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and post care.
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We want it to be like from
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the patient's perspective, their interaction with us,
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it should feel
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like one
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connected
14:52
system.
14:53
We share our protocols. We communicate freely.
14:57
And at the end of it all, we're
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always keeping
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the patient at the center of it.
15:04
We wanted our ultimate goal is
15:08
high quality care
15:10
right here on the Treasure Coast,
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make it easy for our patients to access
15:15
the full depth of the Cleveland Clinic expertise
15:19
when they need it,
15:21
and without
15:22
the burden of have of them having to
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navigate it on their own all on their
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own.
15:28
Yeah. Absolutely. No. That makes a ton of
15:30
sense.
15:31
Doctor Shoudry, last lastly, I just wanted to
15:34
ask you about
15:35
quality and safety. I know that will be
15:37
a core part of your portfolio as CMO
15:39
as well. So as you look across Martin
15:42
Health's three hospitals and outpatient footprint, where do
15:46
you see the biggest opportunities to strengthen that
15:48
reliability
15:49
and care delivery?
15:51
And perhaps what specific
15:52
metrics or initiatives
15:54
will you be watching most closely?
15:57
Absolutely.
15:58
High reliability,
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to me, that means that our patients can
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count on us
16:05
to deliver
16:07
safe, effective,
16:09
and compassionate care
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every time. Not just most of the time,
16:14
every time.
16:16
And it really starts with our Cleveland Clinic
16:19
culture of making safety a non negotiable
16:23
expectation.
16:25
We make sure our caregivers feel safe to
16:28
speak up about any concerns,
16:30
any near misses,
16:32
so that harm will not reach any of
16:34
our patients in our care.
16:37
It's across the board. We don't have a
16:40
single
16:41
meeting, whether it is any of
16:43
our tiered huddles in the morning or an
16:45
executive team meeting,
16:47
without talking about quality,
16:50
patient safety and patient experience
16:52
first.
16:53
That remains first and foremost in our minds
16:56
and that's the first thing that we discuss
16:58
before we step into any other issue that
17:00
we're gonna talk about.
17:02
And as I look across our hospitals, our
17:05
outpatient sites, I continue to, you know, we
17:08
find opportunities to further standardize this care
17:11
for high risk conditions and specifically around
17:15
sepsis.
17:16
Our
17:17
hospital
17:18
system, Cleveland Clinic, has
17:22
partnered
17:23
with different
17:24
technology firms.
17:26
And one of the in specific, our partnership
17:29
with Bayesian
17:31
for our sepsis detection
17:33
algorithms,
17:34
which means that we have it embedded
17:38
in our clinical workflows in the hospital,
17:41
helping our clinicians recognize when someone is at
17:44
a high risk of developing sepsis
17:47
so that we can respond to that sooner,
17:50
we can
17:51
start the diagnosis sooner, we can start treating
17:54
them sooner.
17:56
And the reason why that is important is
17:59
for anyone
18:00
who has developing sepsis and then developing septic
18:03
shock, which means that they're having
18:05
changes in their blood pressure or their mentation
18:08
because of this overwhelming infection,
18:10
for every hour that we can get that
18:12
antibiotic
18:14
earlier,
18:15
every hour reduces their mortality
18:18
by seven percent.
18:20
That is what that this is how we
18:22
want to
18:23
leverage artificial intelligence,
18:26
really strengthen our clinical workflows,
18:28
and improve patient outcomes at the end of
18:30
it. What this does is it reduces variation
18:34
and it helps our teams respond quickly and
18:36
consistently
18:38
every single time.
18:41
Yeah. Doctor Chowdhury, and I love what you
18:43
mentioned just about
18:45
the culture and and how important that is
18:47
in quality and safety. I think it it
18:49
echoes a sentiment that
18:51
we hear often lately, especially from from clinical
18:53
leaders is just that, you know, a lot
18:55
of teams can be good at quality and
18:57
safety initiatives, but culture is truly what drives
19:00
the day to day,
19:02
improvements and sustaining that focus.
19:05
Absolutely. I could not agree more.
19:07
Well, doctor Chowdhury, thank you so much for
19:09
taking the time to join us on the
19:11
podcast today and share your insights with listeners.
19:15
Oh, thank you inviting me. It's really been
19:17
really been a pleasure talking to you, Erica.
19:19
Yeah. Thanks again.