Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Andy Anderson, Chief Medical and Quality Officer at RWJBarnabas Health

Transcript

Dr. Andy Anderson, Chief Medical and Quality Officer at RWJBarnabas Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  Imagine this. You're at the Hyatt Regency Chicago
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  events page. See you in Chicago.
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  Hi. Welcome to the Becker's Healthcare podcast.
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  My name is Paige Twenter. I'm an assistant
• 1:19
  editor here at Becker's Healthcare.
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  I'm thrilled to interview Andy today.
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  Thank you so much for joining me. Before
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  we dive in, I'd love to have you
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  introduce yourself and tell us about your background.
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  Sounds great. Thank you.
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  I am, Andy Anderson. I'm a a physician.
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  I'm a general
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  internist,
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  by training, and I've worked as a a
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  hospitalist
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  and
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  continue to do work as a primary care
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  physician. And
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  I am the chief medical officer and chief
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  quality
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  officer for RWJBarnabas
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  Health,
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  in New Jersey,
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  which is a a health system with,
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  12 adult hospitals and about $7,000,000,000
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  in in revenue. And and my my role
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  here is is essentially
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  heavily focused on quality, safety, and
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  patient experience,
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  and also
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  have oversight of our academic partnership with,
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  Rutgers with regards to our training programs for
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  future,
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  health care professionals, including physicians in in our
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  research infrastructure.
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  So excited to to speak with you today.
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  Yeah. Yeah. Same. Can you tell the audience,
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  you know, a bit about
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  in the past, you know, 6 months to
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  last year, what has been the most successful
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  project or initiative? You know, what what was
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  it and what were the results?
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  Yeah. We've we've been very focused on providing
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  the the best
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  outcomes for for our patients and and for
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  our communities and and working on
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  our patient experience
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  and also on mortality. So I'll focus on
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  mortality,
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  which of course is
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  very important
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  and we've worked on
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  the outcome side with regards to,
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  preventing patients from from dying,
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  but also on the documentation side to make
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  sure we're accurately
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  capturing
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  how sick patients are so that their electronic
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  health record is is up to date
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  and more easily communicated,
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  you know, across the health care team. We've
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  seen a significant
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  result. We've reduced our mortality
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  by over 20% over the past couple of
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  years by really focusing on
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  a few things.
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  One of them is is sepsis. Sepsis is
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  the
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  the infection
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  situation that results in death, and about a
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  third of our deaths are are related to
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  that. And so making sure that we're recognizing
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  sepsis
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  as soon as possible
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  and then intervening,
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  you know, as soon as possible.
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  One of the opportunities there has been our
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  electronic health record, which is Epic, which has
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  an alert system, which in turn goes to
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  our rapid response team who is able to
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  act quickly
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  and intervene appropriately with things like antibiotics and
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  and fluids.
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  We also have,
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  AI tool called the deterioration index embedded in
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  EPIC, which predicts for us if someone's likely
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  to die.
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  And that tool, in turn, also provides the
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  opportunity for our rapid response team and our
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  floor teams to truly go and assess the
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  patient real time and intervene real time so
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  that we can make sure someone doesn't get
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  sicker and make sure they are getting the
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  care that they need,
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  right away. So a lot of good work
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  on our alert system,
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  a lot of good work on making sure
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  that we are rescuing patients who are getting
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  sicker, a lot of good work on making
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  sure that our patients are giving evidence based
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  care and and best practice guidelines to make
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  sure they get to the best outcomes.
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  Yeah. 20%
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  drop is pretty significant. Was it only sepsis,
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  or were there other
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  conditions you all were focusing on?
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  Yes. It was across the board, in terms
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  of the the 20%. Sepsis was a a
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  big area of focus. We also spent
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  a lot of time working on, the mortality
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  review process. When someone does,
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  die, we're able to really go back and
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  see are there things we can learn from
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  this, and then in turn, share that back
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  to the team that was caring for the
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  patient as well as share it as a
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  system learning
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  so that that others can can also learn
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  from it in in the future.
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  We've also done a lot of work on
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  our ICUs in terms of our ventilator management,
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  making sure that we are extubating patients timely,
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  making sure that we're
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  doing things like raising the head of the
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  bed, making sure that we're providing really the
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  best possible care for patients who who are
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  already sick to make sure that they have
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  the best chance of getting better.
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  And with $7,000,000,000
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  revenue and 12 hospitals,
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  how do you,
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  really ensure excellence, like and
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  focus on, you know, these kind of wide
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  scaling big hairy goals?
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  Yeah. Part of it is is articulating
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  the why, you know, why this is important
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  and and really engaging
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  our leaders and our frontline
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  caregivers
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  in the work and making sure that we're
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  all doing the right thing, that we're following
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  those those best practices. And, you know, part
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  of our success I attribute to a team
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  based
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  approach, and we purposely
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  had our chief medical officers, which are our
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  doctor leaders, our chief nursing officers, our nurse
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  leaders, as well as our our quality
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  leaders really partnering
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  together.
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  They're at the table together. They're making sure
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  that they are identifying
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  those best practices, those pathways that are gonna
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  provide the best outcomes for patients.
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  And then making sure that we're all doing
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  it and and really sharing results and trying
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  to lift each other up. If one hospital
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  is doing better in a certain area, we
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  make sure that hospital shares what they're doing.
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  Another hospital is is not doing well, then
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  we have that hospital talk about their challenges
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  and we we problem solve together. So really
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  working together, sharing best practices, and truly operating
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  as an integrated health system is making an
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  enormous difference for us.
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  On the vein of sharing best practices and,
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  you know, problem solving when challenges arise,
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  whether it's with the recent efforts of, reducing
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  mortality
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  or,
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  you know, something else with their recent challenge
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  that
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  r j w RWJBarnabas
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  recently overcame?
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  Yeah. I think
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  the the opportunity for us is is really
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  to reengage
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  our doctors and and our nurses and our
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  our health care professionals.
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  There was a lot of stress,
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  from from COVID,
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  from the financial challenges that all health systems
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  had as we were coming out of COVID.
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  There's there's just a lot going on in
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  in health care, a lot of change, and
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  so that that intensity,
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  has caused some of our clinicians to to
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  burn out. And and so we have a
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  lot of focus on on wellness
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  and making sure that we're supporting
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  our doctors and our nurses and and all
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  of our staff for that matter, in their
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  work. Part of that goes back
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  to having them feel the why, why this
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  is important, you know, why they come to
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  work, and that's very engaging. Part of it
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  is trying to make sure that we're making
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  it easier
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  for everybody to to do their work. Part
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  of that is the electronic health record and
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  and making sure
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  that the EMR is is easier to use
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  for our clinicians.
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  Part of it is just making sure that
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  we are supporting each other,
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  recognizing each other, and thanking each other, you
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  know, appreciating
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  the team that's doing work, you know, makes
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  a huge difference. So
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  really reengaging,
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  and ultimately activating, you know, getting our clinicians
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  and our staff excited about the work they're
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  doing. That's what we're after and part of
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  that is measured through our annual engagement survey
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  and we saw a big jump in those
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  results last year, which is is really important
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  for us because it really takes a fully
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  engaged workforce to be able to deliver
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  the best possible outcomes.
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  Are you thinking of recent example of addressing
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  that burnout and forcing the why or reengaging
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  your nurses and physicians? Was there
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  something in particular you had in mind?
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  Yeah. We've established we call them, wellness
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  committees.
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  Each of our
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  hospitals,
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  established
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  a a group,
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  that would be a a opportunity to listen
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  to issues that come up,
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  in in the hospital. Some of them are
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  little things, simple things that can be
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  easily fixed. Some of them are are more
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  complicated,
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  but having that that forum,
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  to to share,
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  challenges and to share stresses
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  and then and working the list and trying
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  to fix problems,
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  as best we can. The other,
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  tool that I find very powerful is we
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  call it senior leader rounds,
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  where the hospital c suite, you know, goes
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  out to the hospital floors,
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  meets with the staff, listens
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  to any issues or concerns they have. Sometimes
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  it's things like the supply chain function
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  is not correctly working. You know, there's certain
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  tools that that are not in place that
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  need to be there.
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  And some of those things can be fixed
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  real time, which is very powerful to to
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  see your c suite, you know, fixing your
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  problem when you're a staff member on a
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  on a floor unit.
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  So that's been another great tool for us
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  to help problem solve and and to help
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  make the work environment easier for everybody.
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  Mhmm. Yeah. I can only mention how encouraging
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  it is to be, like, that real time
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  fix. Like, as soon as the problem is
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  raised, you know, and not waiting and emails
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  and weeks weeks for something to be over
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  with.
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  We have a few minutes left. I wanna
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  make sure I get to a few other
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  questions. So I'm gonna give you 2 questions
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  at once. One is, you know, how do
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  you see the chief medical and quality officer
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  roles evolving? And then also,
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  to tack on what would be your advice
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  for future aspiring,
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  chief medical and quality officers?
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  Yeah. The the chief medical officer role,
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  I think will evolve to be
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  more of a strategic,
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  you know, business partner
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  as a c suite member
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  within a hospital or within a health system
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  where the chief medical officer,
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  who is really the physician leader,
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  gets more involved in in all aspects of
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  decision making. You know, the physician
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  leader needs to understand the business, and and
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  part of that is is my advice to
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  aspiring
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  CMOs is to understand the entirety of the
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  health care business.
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  Not that someone's gonna become a full subject
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  matter expert in the finances of health care
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  or, you know, how human resources,
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  should work in a health system, but
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  having deeper knowledge and experience and exposure
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  to those different
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  functions is very important because
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  the health care environment is very matrixed, and
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  it's a team based sport. And the more
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  knowledge that a a physician leader can have
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  in those areas, the more equipped they're gonna
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  be able to have a a real conversation
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  when they're at the table talking about strategy,
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  for example.
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  So that CMO
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  role really should be a true business strategic,
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  you know, partner
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  as decisions are are being made.
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  And aspiring CMOs should be equipped to to
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  be part of that conversation.
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  The other part of what I think is
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  important that I mentioned before for aspiring CMOs
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  is really to make sure you are spending
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  time at the frontline to make sure you
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  are going to the hospital
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  unit, having conversations
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  directly with patients, having conversations directly with nurses.
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  And whether it's in the hospital or whether
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  it's in medical office practice or ambulatory surgery
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  centers, it's really important for a physician leader
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  to to be there, to see, to hear
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  directly from the front line so that the
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  person can really understand more deeply what's going
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  on and how they can be
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  helped and and really bring solutions,
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  to those
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  environments.
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  The the last thing I I wanted to
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  mention is is, you know, having
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  a comfort level, you know, with a matrix
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  type environment. You know, a physician leader
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  will be an influencer.
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  And the more that physician leader can have
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  an understanding of the different aspects of health
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  care, the more likely they're gonna be an
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  effective influencer
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  as decisions are being made about strategy,
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  in a health system environment.
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  Mhmm. I would love to hear more about,
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  kind of the influencer role, but we are
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  at time. Thank you so much, Andy, for
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  joining me on the podcast today and sharing
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  your sharp insights with us. For our audience
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  listening today, you can catch more of him
• 14:28
  in our upcoming clinical leadership forum at the
• 14:30
  Becker CEO and CFO roundtable,
• 14:33
  which is taking place this November in Chicago.
• 14:36
  We have limited space available for attendees and
• 14:39
  sponsors, so contact us if you wanna snag
• 14:41
  a spot. Thank you again, Andy. I really
• 14:43
  appreciate it.
• 14:44
  Thank you very much.