Latest / Becker’s Healthcare - Clinical Leadership Podcast / Driving Innovation and Patient Safety at Southcoast Health: A Conversation with Dr. Dani Hackne

Transcript

Driving Innovation and Patient Safety at Southcoast Health: A Conversation with Dr. Dani Hackne · Becker’s Healthcare - Clinical Leadership Podcast

0:00
This is Laura Dirda with the Becker's Healthcare
0:02
podcast. I'm thrilled today to be joined by
0:04
doctor Danny Heckner, chief clinical officer at South
0:07
Coast Health System. Doctor Heckner, it's a pleasure
0:09
to have you on the podcast today.
0:11
A pleasure to be here, Laura.
0:13
Now I'm excited to have you as part
0:15
of this conversation because I know, we'll talk
0:18
about some of the cool things we're doing
0:19
at South Coast, particularly in looking at,
0:22
digital innovation and quality on technology side and
0:25
and delivering that into patients as well for
0:28
positive change. But before we dive into that
0:30
discussion, I'm curious. Could you tell us a
0:33
little bit more about yourself and your background?
0:36
Sure. I'm a Sears UCLA trained pulmonary critical
0:39
care physician,
0:41
still clinically active. I serve as chief clinical
0:44
officer of South Coast Health,
0:46
300,000
0:47
catchment
0:48
hospital system in Massachusetts,
0:52
but also serving, Rhode Island as well.
0:55
I currently hold the Goodspeed,
0:57
chair of quality of safety at South Coast
0:59
and also
1:01
serve as an associate professor at UMass Chan
1:03
Medical School. I served as one of the
1:06
core members of the road map to health
1:08
care safety in Massachusetts,
1:10
which was presented at the health care policy
1:12
forum
1:13
in April 23.
1:15
At the hospitals, your physician advisers may have
1:18
trained,
1:19
with the Compass PA program from the American
1:22
Case Management Association
1:24
that I helped develop.
1:26
And,
1:27
lastly, I'm trained in health care coaching through
1:30
the Health Care Coaching Academy.
1:33
The most important thing is I'm a Boston
1:35
Celtics
1:36
and LA Galaxy fan. There are not many
1:38
of those. A father of five and occasional
1:41
volunteer soccer coach.
1:43
Oh, it's fantastic to hear. And, you know,
1:46
I was curious. How did you become a
1:48
a a fan of both Celtics and LA?
1:51
Well, I originally came, with my family. My
1:53
dad,
1:55
was born in South Africa and and served
1:57
as a family doc, got interested in anesthesia,
2:00
and brought the family to Boston,
2:02
became
2:03
a a Celtics Red Sox fan at that
2:05
time. We eventually made our way to the
2:07
West Coast
2:09
and,
2:10
long time Galaxy fan,
2:13
with my kids,
2:14
and,
2:15
so pleased to see two championships
2:17
in the past year.
2:20
Yeah. Absolutely. That is super, super impressive and
2:23
a lot of fun. So,
2:25
really cool. Well,
2:26
thank you again for for jumping in here.
2:29
Could you tell us also as well a
2:31
little bit about what's driving quality and safety
2:34
journey that you're on at South Coast. How
2:36
are you thinking about the transformation?
2:39
So in my early career, I did work
2:41
at Cedars in the rollout of the core
2:43
measures in medicine,
2:45
and we developed point of care decision
2:47
support,
2:48
to augment very limited quality labor.
2:51
And at South Coast, we've been on a
2:53
very similar mission,
2:55
to drive real time clinical collaboration
2:59
within limitations,
3:01
that our current
3:03
market and and and and current,
3:06
staffing
3:07
require.
3:08
Using augmenting tech technology, we're really driving those
3:12
five core elements of the road map to
3:14
health care safety,
3:16
including leadership and safety culture,
3:19
operations that embed safety behaviors,
3:22
patient family and caregiver support,
3:26
workforce well-being,
3:27
and then a commitment
3:29
to measurement, measurement, measurement, and transparency.
3:33
Absolutely. I I think that makes a lot
3:35
of sense. And, you know, I really,
3:37
love that emphasis on being able to not
3:40
only elevate the safety aspect of it, but
3:42
then to have the measurement,
3:44
clear metrics and transparency as well.
3:47
How easy or or difficult is it to
3:50
make that transformation?
3:51
Obviously, the technology side is one thing, but
3:54
on the people side as well. I'm curious,
3:57
from your perspective,
3:58
what, have been helpful in how have you
4:02
kind of navigated the people side of this
4:04
type of transformation?
4:07
So in that first area, leadership and safety
4:09
culture,
4:10
we have to have sensitivity to operations.
4:13
We have to keep the walls up.
4:15
We we have to treat
4:17
throughput,
4:19
emergency access, primary access,
4:21
and
4:22
and specialty access as quality and safety issues.
4:27
And yet,
4:28
at the core of all of those operations
4:31
are human beings.
4:33
So it means,
4:35
really emphasizing
4:37
deference to those
4:38
human beings' experience, but also
4:41
their clinical expertise.
4:43
One of, you know, the key elements is
4:46
building strong dyadic tri triadic,
4:50
leadership.
4:51
So every every one of my clinical leaders
4:54
has an operations leader at their elbow,
4:57
and
4:58
and they they listen to the clinicians in
5:01
the field.
5:02
They listen to the front office staff, and
5:04
and together, you drive
5:06
operations
5:08
that that are are conscientious,
5:10
that are thoughtful.
5:12
And we've seen this really have a major
5:14
impact on on on experience scores.
5:17
We're running experience scores in our group in
5:20
the nineties.
5:21
I think primary care may be 89.
5:25
We're seeing,
5:27
well-being,
5:29
reported in our culture of safety,
5:32
surveys,
5:33
and we're seeing improvements even in hard hit
5:36
inpatient areas.
5:39
And it's great to see such positive results
5:41
there and truly, truly,
5:43
serving the community and patients in a meaningful
5:46
way.
5:47
I'm wondering, what are some of the digital
5:49
and quality technologies that have helped you accelerate
5:51
this positive change?
5:53
So South Coast marks its tenth year of
5:56
investing in EPIC and robust tools,
5:59
to enhance clinical care.
6:02
We're a premier client for our data warehousing
6:04
and benchmarking
6:06
capabilities. We're also an NRC client
6:09
for benchmarked
6:10
experience data.
6:12
Our visualization
6:13
platform is Tableau.
6:16
And then we've also adopt adopted some of
6:19
the needed elements,
6:21
such as Compass Rose for care navigation,
6:23
MyChart care companion,
6:26
which is very similar to other commercial products
6:29
for patient education and engagement.
6:32
But we also have an innovation arm called
6:35
Compodio that invests
6:37
that invests in educational and improvement technology
6:41
and also brings some of our innovation to
6:43
the market.
6:44
We're a level 10 CHIME most wired organization,
6:48
so we're very much committed to this nexus
6:50
of
6:51
of of people and technology.
6:54
You know, lastly, we have an AI center
6:56
of excellence.
6:57
It's recognized by American
7:00
College of Radiology.
7:02
We use AI
7:04
to manage cues,
7:06
never to diagnose
7:08
but to enhance throughput.
7:10
And,
7:11
and all of these
7:13
digital applications
7:14
together in a thoughtful way,
7:17
can, can make a difference.
7:20
Absolutely. That makes a lot of sense, and
7:22
I appreciate you outlining
7:24
some of the different,
7:25
technologies that have supported you through these journeys.
7:27
It's oppressive to hear, the level 10 chime
7:30
in in most wired recognitions as well as
7:33
the others from the American College of Radiology
7:35
in in other areas that,
7:37
truly, you know,
7:39
show how distinguished you are in the things
7:41
that you're doing at South Coast. That that's
7:43
really cool to hear.
7:45
In achieving or or making these achievements, how
7:47
has your team evolved throughout this journey?
7:51
Well, I'd I'd like to act, sort of
7:54
just,
7:55
you know, pull back the covers a little
7:57
bit and just explain,
7:59
before
8:01
how we apply the technology.
8:04
We have a fairly,
8:07
simple approach at at a high level.
8:10
So we like to combine,
8:13
available raw financial and operational data
8:17
together with,
8:18
processed
8:20
risk adjusted
8:21
data.
8:23
And we like to share it
8:25
across
8:26
our our organization from the board
8:29
to the front front
8:31
line.
8:32
And the way to do that is delivering
8:35
simple, meaningful visualizations
8:37
to staff
8:39
so they then have choice
8:42
and engagement,
8:43
understanding,
8:45
and then can decide on their test of
8:47
change. They can,
8:49
engage in idea generation.
8:52
They can
8:53
course correct,
8:54
and, most importantly,
8:55
internalize the improvement process.
9:00
So, you know, our organization and I believe
9:02
that health care personnel
9:04
are highly creative, and they're internally driven, but
9:07
it's our responsibility
9:10
to give them the tools, including the digital
9:12
tools.
9:13
As we've talked about earlier, it's really important
9:17
that we recognize the human factors,
9:20
and we have to find ways to
9:24
join robust process improvement
9:27
and agile workouts
9:29
with
9:31
an understanding
9:32
of the experience
9:34
of the providers and staff in the moment.
9:38
Folks have had probably one of the toughest
9:41
seasons in
9:43
in in seven years with with the flu
9:46
this this past winter. And
9:49
how can we, even during that really tough
9:52
season,
9:53
maintain and improve the experience of providers which
9:57
we have?
9:58
And and it's this combination
10:00
of attentiveness to
10:03
the the quality methodologies
10:05
and and the digital tools, but also
10:08
the experience of the individual in the moment.
10:11
You know, to do that, it sometimes requires
10:14
that we step back
10:16
as leaders
10:17
and
10:18
and allow
10:19
our teams and leaders
10:22
to innovate, to stub their toes.
10:25
Other times, we really should look beyond our
10:28
own institutions.
10:30
We've had wonderful collaborations with organizations
10:33
like the Betsy Lehman Center,
10:35
the CDC see difference collaborative,
10:38
our local public health officials,
10:41
such as our new New Bedford
10:43
and Fall River Public Health Leaders and and
10:46
then national organizations like NACCO, the National Association
10:50
of Community Health Officials.
10:52
And,
10:53
you know, sometimes leaders in a particular system
10:57
really need to just listen,
10:59
you know, outside of your own system and
11:02
and then bring in some of those best
11:04
practices
11:05
and and learnings.
11:07
So at South Coast, we're committed to making
11:10
a meaningful difference,
11:13
and it and and it involves,
11:15
really a lot of thoughtfulness,
11:17
but also
11:19
humility before the the data and the people.
11:22
So to really get to your question on
11:25
how the team has evolved
11:27
through this journey,
11:29
the team is really committed
11:31
to an open
11:33
and collaborative
11:35
as well as distributed approach
11:37
to improvement.
11:39
So
11:40
it it's a a normal practice at South
11:43
Coast to embed quality staff
11:46
in a clinical area,
11:48
such as
11:50
our top rated three star
11:53
cabbage
11:54
program and our wonderful structural heart program.
11:58
That quality staff is seen as part of,
12:02
the operation and, of course, can't do do
12:05
everything. That's where the dyadic,
12:07
triadic
12:08
relationships come into play.
12:11
And then
12:12
in areas where we've seen need, we've replicated
12:16
best practices
12:17
across disciplines and geographies.
12:19
So
12:21
when we saw an opportunity
12:23
with our wonderful nursing
12:25
staff to
12:27
develop professional practice
12:29
and simulation training and and a number of
12:33
other
12:34
elements,
12:35
we replicated
12:36
what may have been available,
12:38
to
12:39
to another part of our center or even
12:42
what was available outside our center.
12:45
So now, for instance, nursing peer review is
12:47
on par
12:48
with physician and HPAPP
12:51
peer review.
12:54
We've also developed and mentored leaders because
12:58
in some areas, folks just haven't had exposure
13:02
to
13:03
the challenge and, frankly, some of the mistakes
13:05
we've made in other areas and learned from
13:08
and and mentoring,
13:09
developing
13:10
leaders that are motivated
13:13
and and enjoy this approach
13:16
has really yielded wonderful
13:18
results.
13:20
In some cases, we've sent folks to
13:23
individual leadership training programs.
13:26
I've
13:27
I've had some success with the Harvard women's
13:29
leadership program,
13:31
and,
13:31
we've really turned the light on.
13:35
One of our hospitalist leaders,
13:38
did a wonderful AI program.
13:40
And, and so there are many
13:43
ways to mentor and develop
13:45
on both the technology side, but also
13:48
on on the human side.
13:51
And lastly,
13:53
you know, we've gotta flex
13:54
our our muscles in this area
13:57
even when events do not occur. And one
13:59
of the best ways to do that
14:02
and and to keep trained up is case
14:04
based learning.
14:06
So we do simulation training and case based
14:09
learning
14:10
with multidisciplinary
14:11
teams.
14:13
And,
14:14
and I do a very similar session at
14:16
the Harvard School of Public Health in the
14:18
summer,
14:19
for a day,
14:20
where we look at case based learning around
14:22
the leadership challenge.
14:25
And and these approaches within the health system
14:29
are very well received. You'll have a a
14:31
risk manager next to a quality nurse, next
14:34
to a professional practice peer review,
14:37
specialist,
14:38
next to a provider
14:40
physician
14:41
APP, next to an operations person,
14:45
and work through some challenging
14:48
events.
14:49
And we've dealt with issues such as workplace
14:51
violence, which
14:53
can be,
14:55
you know, can be dealt with in a
14:56
simulation
14:58
environment
14:59
quite safely,
15:00
but helps folks to prepare, helps folks to
15:03
address some of,
15:05
some of the challenges, but also some of
15:07
the opportunities.
15:09
That's great to hear. And and certainly,
15:12
such
15:13
a, important
15:15
aspects you're talking about here in in continuing
15:17
education and learning and how people can grow,
15:20
with new opportunities
15:21
as well as elevate themselves throughout their careers.
15:25
I'm curious before we wrap up here, what
15:27
are you most excited about for the next
15:29
year, and what makes you nervous?
15:32
Well,
15:33
I would say I'm very excited
15:36
about
15:36
our work on empathy training. We partnered with
15:40
a wonderful evidence based program, the company called
15:43
Empathetics,
15:44
doing a train the trainer
15:46
program rolled out to our hospitalists.
15:49
We learned from an organization on the West
15:52
Coast that,
15:53
did very well
15:55
with the program,
15:56
and, we're continuing to roll it out for
15:59
hospital based providers,
16:01
this winter
16:02
and spring.
16:04
I'm also very excited about our dementia work
16:06
with the guide program, and this brings folks
16:09
from
16:10
across the system,
16:11
ambulatory, inpatient,
16:14
home health, and and beyond.
16:17
We're including innovations from compodio.
16:20
We're using some new technology on AI language
16:24
and visual recognition,
16:27
and,
16:28
we're embedding it in our brain and spine
16:30
center, an ambulatory
16:32
memory clinic,
16:33
you know, that has, guide support.
16:37
And,
16:38
lastly, I'm very excited about
16:40
the overall journey
16:42
to high reliability,
16:44
you know, supporting,
16:46
our movement and our star ratings
16:49
and,
16:50
and and the well-being of
16:53
of our our staff and community.
16:56
What am I worried about in the coming
16:58
year?
17:00
Health care is really tough,
17:02
at this time. It's a market
17:05
that's quite disrupted.
17:08
On one hand,
17:10
increased
17:11
compensation,
17:13
for labor
17:14
has provided benefits
17:16
to some who have been overlooked in the
17:18
labor pool in the past, but it's also
17:20
created,
17:22
high costs
17:24
with diminishing
17:25
reimbursement.
17:27
And everyone is, struggling
17:30
how to
17:32
do more
17:33
with an aging population
17:36
and and serious challenges,
17:38
to community health.
17:40
We're we're looking at innovations
17:43
in in the community settings as well as
17:44
the hospitals, but,
17:47
across the country, we see colleagues
17:50
who are equally challenged. And and so that
17:53
that continues to worry me.
17:56
Absolutely. It's such a tough balance right now
17:59
for hospitals and health systems
18:01
across the board, especially as you mentioned, just
18:04
so many pressures coming from,
18:07
the workforce side,
18:09
as well as financial challenges, trying to to
18:12
navigate through. And so it's it it it's
18:14
really great to hear, some of the things
18:16
that you've been able to do, to continue
18:19
providing care, but I can imagine, you know,
18:20
some of these looming headwinds,
18:23
certainly,
18:24
can color how you're thinking about, building up
18:27
programs and and, what you need to do
18:29
in order to sustain success in the future.
18:33
Absolutely. It's it's definitely exciting to work,
18:37
and
18:38
I would definitely say that the staff and
18:40
the patients,
18:42
give back much more than they receive.
18:44
So
18:46
if you enjoy the delayed gratification,
18:48
there is gratification in this work.
18:52
And, you know, I I would encourage,
18:55
folks who at at times may be facing
18:57
headwinds,
18:59
to reach out to colleagues,
19:01
go beyond your institutions
19:03
to share,
19:05
and, and then just consider
19:08
some of the programs that that we use
19:11
and,
19:12
and investing
19:14
in the well-being
19:16
of your staff.
19:17
It it's paid off for us, and,
19:20
we're learning every day.
19:22
The the work's tough, but it's very rewarding.
19:25
Absolutely. Doctor Hackner, thank you so much for
19:27
joining us on the podcast today. This has
19:29
been, just a really fantastic conversation, and I
19:32
look forward to connecting with you again soon.
19:34
Thank you very much.