Latest / Becker’s Healthcare Podcast / Naman Mahajan, President of Baylor Scott and White Grapevine

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Naman Mahajan, President of Baylor Scott and White Grapevine · Becker’s Healthcare Podcast

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in Chicago.
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This is Laura Dirdo with the Becker's Healthcare
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podcast.
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I'm thrilled today to be joined by Naman
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Mahajan, president of Baylor Scott and White Grapevine.
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Naman, it's a pleasure to have you on
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the podcast today. Thank you for having me,
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Laura. Now I'm excited to have our conversation
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because I know there's so much happening in
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health care today and particularly some really cool
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things you're doing at Baylor Scott and White.
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But before we dive in, can you tell
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us a little bit more about yourself and
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the hospital?
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Sure.
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So, Naman Mahajan, president of Baylor Scott and
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White Grapevine. Been here a little over three
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and a half years.
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Background is, been in health care. Gosh. It's
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been a long time now. So close to
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almost twenty years,
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in in health care. And,
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Baylor Scott and White, we are the largest
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not for profit health system in Texas. We
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have over 1,300 care sites, 57,000
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employees,
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and we have a heavy concentration in North
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And Central Texas.
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For our Grapevine location,
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we aim to serve our community, which basically
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goes all the way from Dallas to Fort
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Worth. There's about a million residents that are,
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within our service area, and our goal and
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aim is to serve those residents in our
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community as that tertiary care facility.
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So residents who live within our service area
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don't have to migrate to either downtown to
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receive world class, health care.
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Absolutely. That's great to hear. No. It's so
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important to have that care close to home
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and really make sure you're providing services to
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the community that are accessible,
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and affordable.
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Now I'm curious. What can you tell us
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about the most important initiatives that you've led
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in the last year? What did you do,
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and what were the results?
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Sure.
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You know, really nailing it down to one
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kind of becomes tough, but I think it's,
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it's really bifold.
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One is really looking at our employee engagement
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and our team member turnover,
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and then
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combining that with really and I think this
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is a national issue over here, is throughput
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and capacity management.
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So those were two big initiatives that we
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as a senior leadership team focused in on
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going into the last year of where where
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we could really make an impact.
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And when we really dived into our data,
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the challenge that we had was really looking
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at first year turnover
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for our non licensed team members.
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In particular months, we had exceeded 30%
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when you looked at, historical turnover rates for
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that group of, team members over there. Now,
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obviously, we don't lose any of our team
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members, but we really started diving in in
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collaboration with our HR, with our nursing team,
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and other leaders of what was causing that
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turn
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over. And what we came to realize was,
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it was really a scope of responsibility
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that when you looked at our nursing managers,
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for example, on a unit, not only did
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they have all the nurses, but now you
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have all the the health unit coordinators, the
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patient care technicians, all of those in individuals
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were rolling up to one,
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one leader, and they really couldn't give them
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enough time and the support needed, especially within
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the first year to really get their legs
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underneath them. And with health care being
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challenging and, you know, units being full, that
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was an area we really dived into.
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So something that we did with that was,
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smooth out our scope of responsibilities
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for not only our nursing managers, but our
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supervisors.
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And what this did was we put all
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of our non licensed personnel
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with the responsibility
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rolling up to the supervisor of the unit.
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So we saw a significant decrease in first
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year turnover.
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And secondly, as a byproduct of that, we
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also
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help strengthen our bench strength for future leaders
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within the organization.
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Because another challenge that we looked at was
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supervisors really historically did not have personnel responsibility.
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So having personnel roll up to them, they've
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gotten,
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used to, you know, looking at
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engagement,
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looking at team member, career growth and development,
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disciplinary action. So this really does prepare our
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future,
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bench strength and future leaders within the organization.
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Now you combine that with looking at, throughput
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and capacity management,
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did a lot of work with this and,
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could not have done it without our hospitalist
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group and our hospitalist leadership.
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We started,
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several,
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initiatives here, and I'll go through a couple
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of them and and some of the results
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that we've had. So we've historically had multidisciplinary
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rounding.
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However, when we really dug into the data,
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were those multidisciplinary
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rounds led by the physicians
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really increasing our discharges before 10AM, noon, whatever
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benchmark you wanna look at. And oftentimes,
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we would miss on those. However, there was
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really never any follow-up of why those that
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patient was not able to discharge by a
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particular time. So what we started doing was
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adding a two PM check back in of
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we thought patient x, y, and z was
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gonna leave this particular unit, and if they
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did not, what were the challenges and how
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do we mitigate that, and hopefully in the
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future combat that so that doesn't become a
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challenge.
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And this is not only led by physicians,
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but we have our entire gamut all the
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way from imaging services, lab services, nursing team
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members,
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case management as part of these calls, really
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digging into that. We have significantly
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been able to increase our percentage of patients
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that are discharged before noon over here.
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And then
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on the weekends, what we realized was, you
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know, it was much harder to get everyone
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physically into the building, so we added a
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virtual option. And that also has been successful
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of increasing the number of patients that are
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actually discharging on the weekends.
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The other initiative that we put into place,
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which, I would highly recommend that all leaders
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really look into
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is a discharge, and we call it a
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hospitality suite. So if your care plan has
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been complete
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and you are ready for discharge, however,
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your ride is not available or another thing
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is precluding you from leaving the building, we
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actually can get you out of a patient
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room into a nice area with lounge chairs,
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TVs,
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etcetera,
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where you can wait for your ride. In
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addition, what we did with this is actually
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all of our discharge paperwork is completed downstairs
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in this hospitality suite.
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When you look historically and nationally at one
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of the big challenges we face as a
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health care industry
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is discharge instructions. Does a patient really understand
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how to maintain their health outside of the
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hospital so they don't have to come back
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into a hospital in terms of a readmission
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or staying healthy outside. So with medication reconciliation,
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discharge education, all of this is done by
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the nurse in the discharge hospitality suite. And
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when you look at patient experience between the
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overall group and the, patients that discharge to
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this hospitality suite, there is a marked increase
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in,
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patient experience scores when you look at the
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domain of discharge instructions over here. So we
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are keeping our patients healthier, getting them out
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of their patient rooms sooner.
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And, typically, when we measure how long does
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a patient stay in this hospitality suite, it
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is under an hour. So, you know, it's
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it's a it's a great win all the
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way across, the board over here.
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That's amazing to hear. And, you know, really
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cool to have that opportunity not only to
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continue to build up your bench of talent
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and leadership and engage employees in a more
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meaningful way, but also having that
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kind of match with some of the capacity
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management as you've been talking about, figuring out
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how to make sure you're moving patients through
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and giving the right,
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instructions as well as, processes
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to understand when things don't exactly go as
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planned, how you can continue to work and
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improve that in the future. I think that's
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so critical because, you know, oftentimes when I'm
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talking to executives,
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that capacity management, as you said, really comes
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up, as something that not only, you know,
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is a challenge right now, but many anticipate
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will continue to be challenging in the future
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given demographic shifts and other,
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factors happening in the health care space. Just
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really looking for ways to,
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make sure that the entire hospital organization is
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running efficiently so that you can continue to
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serve patients who need that inpatient care,
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and operate at the right capacity.
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Absolutely.
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Now when you're looking ahead, what are some
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of the big priorities and headwinds that you're
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focused on for 2026 and beyond?
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Sure. So
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I don't know if I'd exactly call this
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a headwind, but,
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what we do see you know, Texas is
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one of the fastest growing states, in America.
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Economy is strong. And the DFW Metroplex,
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we continue to see an in migration over
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here. So our challenge really is our
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service area and our,
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patient population continues to grow. And while we
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are blessed to have a well capitalized organization,
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beds take time to build. You know, even
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if we say today, I need x number
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of new beds, it's gonna take a multiyear
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process to get those beds operational
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and, up and running over here. So I
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think, capacity management really is gonna be
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a challenge for us universally in health care.
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And as you said, it really goes into
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resource management and how do you,
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ensure that you're providing the highest level of
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care for our community
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in the most, expeditious and, cost effective manner
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possible. So I think that is gonna be
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a challenge.
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But really, where this comes into and,
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when you look at us in a competitive,
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health care space, how do you win the
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preference of both physicians
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and patients?
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Because you need both in order to have
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a successful organization.
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So from a patient perspective, what we have
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really challenged our physicians with is a commit
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to sit program.
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And, this actually came from a personal experience
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of mine. We have a two and a
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half year old daughter.
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And about six months ago,
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overnight, she developed this rash all over her
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body. And, so we brought her to our
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emergency room over here. And, obviously,
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my wife and,
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mom was very, very nervous, scared, etcetera. And
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me being in the health care thing tried
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to play it off cool, but, obviously, I'm
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also nervous and scared about what's happening to
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my child.
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And the biggest difference,
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what really calmed me down and set this
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from a patient's perspective
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was when the physician actually sat on the
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sofa next to my wife, walked her through,
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what exactly was going on with our child,
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and that
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demeanor and that approach
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calm the whole situation down. So from a
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personal experience,
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brought that back to the team. We've been
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talking about this for a while, but really
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honed in of how much of a difference
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that can make. And so we have made
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a concerted effort that in every patient room,
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we have a chair
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that the physicians, as they come into the
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room,
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will utilize and sit at the head of
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the bed with the patient. And many studies
11:11
have shown, and we have actually seen it
11:13
in our patient experience scores,
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when the when the physician sits at the
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head of the bed and, has a conversation
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with the patient, their perception, even though the
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time spent is the same, is that the
11:25
doctor was much more attentive, doctor communication scores
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go up, doctor listens to me goes up,
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and it is a much more calming environment
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over here. So, you know, that is a,
11:35
program that we launched about four months ago,
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been very, very successful in the initial steps.
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In fact, our physicians are saying,
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that they are actually utilizing this, and even
11:45
some of our naysayers at the early onset
11:47
have really bought into this because they can
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feel the presence too.
11:51
It is a much more
11:53
meaningful conversation that they're having with the patients
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at the sitting level instead of just standing
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at the foot of the bed, and the
11:59
patients definitely feel that too. Now the second
12:02
component to that really goes into
12:04
operations of how do you win the preferences
12:07
of physicians.
12:08
90% of our specialists that utilize our hospitals
12:11
are independent providers that have a choice of
12:14
many different organizations that they can go to.
12:17
And how we have decided to win the
12:19
preference of physicians
12:21
is, you know, this is a saying that
12:23
I often share with our senior leaders.
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The only currency that I have,
12:27
with physicians that are independent
12:29
is efficiency and time back at the end
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of the day. That if they choose to
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operate here in our hospital,
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are their cases starting on time? Do we
12:37
have the right preference sheets? Is all the
12:39
equipment up running functional that they can have
12:42
a smooth experience? Are we flipping ORs over
12:44
here? Is anesthesia a great partner with us
12:47
and really helping to run the boards over
12:49
here to make us the most efficient organization?
12:51
And this goes all the way to our
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units over there.
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Anytime we onboard a new physician, we actually
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bring them up to the units,
12:58
and, we encourage them to do a lunch
13:01
and learn with the particular unit that they
13:03
will be admitting their patients on so our
13:05
nursing team can understand the preferences of the
13:07
physician,
13:08
especially with surgical specialties and neurosurgery, orthopedics, etcetera,
13:13
of do we understand a physician's protocols. And
13:15
oftentimes, what this will do when we understand
13:18
their preferences of how their how they would
13:20
like their patients treated and their care plan,
13:23
we can avoid those unnecessary phone calls. So
13:25
if we operate a
13:27
highly efficient procedural area, can get physicians out
13:30
earlier, or they can add in a couple
13:32
more add on cases.
13:34
When they look to book their next case
13:36
tomorrow, where are they gonna choose to book
13:38
their, cases? So those are two
13:42
opportunities that we have really delved deeply into
13:45
and are committed as nonnegotiables
13:47
for for our organization.
13:50
Well, that's really impressive to hear about, especially,
13:52
you know, thinking through
13:54
the patient experience and that coming from your
13:57
own personal experience and then being able to
13:58
accelerate and bring that to every single patient
14:01
room that you have, is so critical to
14:04
that,
14:05
really overall care journey. And then, you know,
14:07
thinking through the provider side as well, it
14:09
seems like, it's so critical these days to
14:12
have that type of speed and agility when
14:14
you're thinking about,
14:16
you know, bringing in physicians and and making
14:18
sure that you're the facility of choice for
14:20
them. So in in kind of standing up
14:22
this program and, you know, traditional preferences and,
14:26
how you can partner with them in a
14:27
strong way, was it pretty simple? Was there
14:30
anything that you had to do, you know,
14:33
I guess, for others who are maybe trying
14:34
to think about the same things that, you
14:36
know, was really surprising or
14:38
energizing for the team when you're standing up
14:40
a program like this?
14:42
You know, I wish that that there was
14:44
a single magic bullet that, you know, we
14:46
could make health care much more
14:48
efficient and agile for everyone out there, but
14:50
it's really comes into your day to day
14:52
blocking and tackling. One thing I would recommend
14:55
to all leaders out there is,
14:57
you know, while we do have formal medical
15:00
staff leadership positions, medical executive committee, etcetera,
15:03
it is important to to know your constituents.
15:06
And something that I like to do is,
15:09
have a physician advisory group, and these are
15:11
more informal leaders, but they're the thought leaders
15:14
out in the in the community and with
15:16
their peer group over there. So as we
15:18
look at strategic planning, capital deployment,
15:22
house based physician groups,
15:24
These are the key physician leaders that I
15:26
bring in, along with our senior, other senior
15:29
leaders to really help,
15:31
drive the buy in and, have their voice
15:34
on the table too. Because when you have
15:36
a very engaged medical staff and they feel
15:38
part of the process,
15:40
you know, we take pride in saying this
15:42
is our hospital.
15:43
I use my hospital. Our physicians utilize their
15:46
hospital when they or their loved ones need
15:48
care. And when you have that personal stake
15:51
into the organization that you work for,
15:54
you take a lot of pride, and, we
15:56
want the very best for our community and
15:58
also for ourselves as, as members of our
16:01
community over here. So I would highly encourage,
16:04
openness,
16:05
transparency,
16:06
and really bringing
16:08
in key medical staff members as part of
16:10
that senior leadership team and thought leaders
16:12
because sitting in the doctor's lounge, they will
16:15
be either your biggest advocate or your biggest
16:17
naysayer.
16:18
So that would be my, one piece of
16:20
advice.
16:21
That is so, so helpful to know. Thank
16:23
you for digging a little bit deeper there.
16:25
Now I know there's a lot of,
16:27
great things happening, but, you know, the future
16:30
is is certainly a lot of uncertainties
16:32
there too. So,
16:34
what do you think is the hardest thing
16:35
you'll have to do in the coming year?
16:38
For us, and I think for most health
16:40
care leaders, is
16:41
how do you have that best value proposition
16:44
for your community and your various stakeholders out
16:47
there? When you look at cost based health
16:49
care, you know, we have ambulatory surgery sites.
16:52
We have,
16:53
urgent cares, primary care. So how does an
16:56
acute care hospital still stay relevant? And I
17:00
think what differentiates us
17:02
and where the value proposition comes in is
17:04
that when I I'd refer us back to
17:06
our my first comment is serving that community
17:09
serving our community as a tertiary care facility.
17:13
And, you know, this is not a easy
17:15
overnight button, but we serve our community, the
17:17
million people that live within our 20 cities
17:19
that we serve, as our area's only trauma
17:22
level two center. We are comprehensive stroke certified.
17:26
We have a top 100 ED in the
17:28
nation, sees about 55,000
17:30
ED visits a year,
17:32
level three NICU, level three maternal designation, and
17:35
our cath lab,
17:36
when you look at door to balloon time,
17:38
performs in the top 5% nationally.
17:40
I think having those key
17:43
very high acuity services,
17:45
it has led to a great partnership with
17:47
our EMS providers.
17:49
In fact, over seventy five percent of our
17:51
total admissions come through our emergency room. So
17:53
it truly functions as our front door of
17:55
the hospital.
17:56
Every month, we deliver about 200 babies to
17:59
our community and,
18:00
you know, those
18:02
and being out there with those high acuity
18:04
services, providing high quality care and high quality
18:07
outcomes,
18:08
the word-of-mouth
18:09
from our,
18:12
our community, our team members, we really take
18:15
pride in the area that we work in.
18:17
And so anytime
18:19
our community knows, and I'm out there in
18:21
the community educating as well, here are all
18:23
the services that we offer here locally
18:26
and really utilizing our EMS partners to be,
18:30
the biggest advocates for us out there.
18:33
I think, you know, looking forward,
18:35
maintaining those relationships,
18:37
deepening those relationships,
18:38
it is gonna be our path to success.
18:41
That's really great to hear. And certainly, you
18:43
know, a lot out there, as you mentioned,
18:45
thinking through that value proposition and having the
18:47
right staff in place and team and then
18:49
understanding,
18:51
you know, the ways that,
18:53
health care is changing is certainly, certainly helpful.
18:56
Before we wrap up here, I'm curious, where
18:58
do you see the best opportunities for growth,
19:01
across the hospital health system?
19:03
I think this is, it truly is market
19:06
and community specific.
19:08
It is really understanding your
19:10
demographic and the community that you serve. And
19:12
I think that can only come from being,
19:15
you know, heavily integrated into the community, finding
19:18
where are those,
19:19
disparate needs for each community that you serve.
19:22
You know, part of our vision and values
19:25
for Baylor Scott White is empowering you to
19:27
live well.
19:28
And this really speaks to the heart of
19:30
where we are, in health care. And that
19:33
doesn't mean, yes, absolutely, we will be here
19:36
for those high acuity needs, but being a
19:38
partner to the community of empowering them to
19:40
live well outside of the hospital.
19:42
Technology,
19:43
AI,
19:44
our app over here,
19:46
you know, I'll give you one example, and
19:48
we call these patient journeys. And the patient
19:51
journey doesn't start when the when when they
19:53
present themselves to the to the hospital.
19:55
It is the patient journey starts, how do
19:57
you keep a patient healthy? So for a
19:59
mom that just delivered a baby, we actually
20:01
offer as part of our health care continuum,
20:04
through our app for six months post delivery,
20:08
they have ability to 02:00 in the morning,
20:11
your baby is screaming, you don't know what
20:13
to do, you can actually access a virtual,
20:17
nurse and go through the symptoms of what
20:20
your baby is experiencing,
20:21
and they can provide guidance of, is this
20:23
normal? Do you need to go to an
20:25
emergency room? Can this wait for your pediatrician
20:27
in the morning?
20:29
And, you know, offering those services to the
20:31
community,
20:32
Healthcare has become much more consumer centric now.
20:36
And when if Amazon knows that you're running,
20:39
you know, short on dog food and your
20:41
next dog food delivery shows up at your
20:43
doorstep without you even having to think about
20:45
that, How do we as health care become
20:48
that integral into the lives of the community
20:51
that we serve? So it's not only there
20:53
for the acute times that you need, but
20:55
we are truly a health care partner for
20:57
your entire continuum,
20:59
and your and your journey to live well.
21:02
I love that. That's such an amazing philosophy
21:04
and and, you know, really truly thinks about
21:07
the patient and has them at the center
21:09
of what the care can and should be.
21:11
Thank you so much, Naman, for joining us
21:13
on the podcast today. This has been a
21:15
really, really fun conversation. I look forward to
21:17
connecting with you again soon. And, really, you
21:20
know,
21:20
seeing you in April, I know you'll be
21:23
speaking at our annual meeting, which will be
21:25
such a a fun gathering in terms of
21:27
so many different leaders from across the country
21:29
talking about how they're thinking about challenges as
21:32
well as some of the great programs and
21:33
initiatives that they're working on. So I'm sure
21:35
we'll continue this conversation and looking forward to
21:37
seeing you next year. Absolutely. It's been a
21:39
pleasure, Laura. Thank you so much for your
21:41
time.