Latest / Becker’s Healthcare Podcast / James Mladucky on Flexible Design and Strategic Growth at IU Health

Transcript

James Mladucky on Flexible Design and Strategic Growth at IU Health · Becker’s Healthcare Podcast

0:01
This is where health care leadership comes together.
0:04
Becker's sixteenth annual meeting brings more than 3,500
0:07
hospital and health system executives and nearly 800
0:10
speakers to Chicago,
0:12
April 13 through the
0:14
sixteenth. This year's event includes keynote conversations with
0:16
Dallas Cowboys legend Troy Aikman and former president
0:19
George w Bush. For the agenda and event
0:22
details, visit beckershospitalreview.com
0:25
and click on the events tab in the
0:26
upper right. We're looking forward to hosting you
0:29
in Chicago.
0:31
This is Scott Becker with the Becker's Healthcare
0:35
Podcast.
0:36
I am thrilled today to be joined by
0:37
somebody who's had a fantastic career
0:40
at the intersection of health care design and
0:42
construction.
0:43
We're joined today by James Maladecki.
0:46
James currently serves as the vice president of
0:49
design and construction at IU Health. IU Health,
0:51
of course, is one of the great health
0:53
systems in the country, great academic medical center,
0:56
and a great community system.
0:58
I I know, James, you've been there for
0:59
ten years. Before that, you served in a
1:01
leadership position at Northwestern Medicine,
1:04
through the time of some of their biggest
1:06
construction projects. So so what a pleasure to
1:08
visit with you. Can you take a moment
1:10
and tell us about yourself and your career?
1:13
Sure. Happy to, Scott. Thank you for having
1:15
me. Really appreciate the opportunity.
1:17
As you mentioned, I've I've been
1:20
on this side of the fence,
1:22
on the owner's side for a while now,
1:24
since 2010
1:25
is that's when I joined Northwestern.
1:29
I came to IU Health in, 2016.
1:33
Prior to Northwestern,
1:34
though, I was
1:36
a healthcare
1:37
planner and architect
1:39
and principal at both Canada Design and Perkins
1:42
and Will
1:43
for
1:44
thirty years, twenty five years, something like that.
1:47
And, have a unique background in that, also
1:50
did some,
1:52
facility planning with
1:54
a boutique firm called Space Diagnostics in Madison,
1:58
which became part of
2:00
KSA Healthcare,
2:02
probably in the mid two thousands.
2:04
So,
2:05
been on the on the planning
2:08
and design side of health care,
2:11
for my entire career, and so this is
2:13
a great opportunity at IU Health
2:15
and,
2:16
one of, what I'm happy to share with
2:19
you.
2:20
Just just fantastic. And talk about in sort
2:23
of construction and design.
2:25
It's such a changing time. On on on
2:28
one hand, you've got sort of COVID that
2:30
changed a little bit about how systems were
2:32
designed and what they're trying to do. There's
2:34
also the movement to ambulatory.
2:36
There's also, in a lot of portfolios of
2:39
hospitals,
2:40
some very dated hospitals that people have to
2:42
figure out. Can they renovate or rebuild?
2:45
Take a moment on sort of what are
2:46
some of the trends
2:48
that you focus the most on and then
2:49
are most top of mind in in your
2:51
position.
2:52
Happy to. Yeah. Yes. So, you know, what
2:55
I would say is you're right. The the
2:57
portfolios
2:58
of of health care facilities
3:00
are aging,
3:02
and IU Health had a similar problem both
3:05
with Methodist Hospital and University Hospital, and that's
3:08
why we're combining those
3:10
those two. They're about a mile and a
3:12
half apart to build a brand new facility,
3:17
one of the larger ones in the country,
3:19
frankly, and it's and it brought the unit
3:21
or the university school of medicine to this
3:24
campus as well. So now we're we're really
3:26
designing a health care science campus.
3:30
But anyway,
3:31
what I would say is
3:34
flexibility
3:35
has always been key in how you adapt
3:37
a facility to
3:39
the changing
3:40
requirements
3:41
of how we deliver care,
3:43
how we integrate teaching and research into that
3:47
care on a daily basis
3:49
was one of
3:50
the cornerstones of this project.
3:53
So
3:54
the challenge that I was given was how
3:57
can you design something
3:59
that
4:00
will be the least expensive
4:02
to adapt
4:04
over its lifetime.
4:06
So,
4:07
a
4:08
a very tall order
4:10
and,
4:11
and so we spent quite a bit of
4:13
time on
4:14
how a facility
4:17
is designed and what are the
4:20
limitations
4:21
that would allow it to adapt.
4:24
And so, the structural system being probably the
4:27
primary one,
4:29
So we thought about that, and, I can't
4:31
say this is this is new
4:34
to design, but
4:36
or at least the the thought of how
4:39
to design
4:40
a facility.
4:42
But, we we settle in on a base
4:45
size that allows
4:46
for either
4:48
two patient rooms
4:50
or it could be that base size also
4:53
allows or does allow for
4:55
one OR
4:57
or three
4:58
ambulatory exam rooms
5:00
or two imaging rooms. And in fact, even
5:03
wet bench research would fit in
5:06
that
5:07
bay.
5:08
So that allows for that flexibility
5:11
over time,
5:12
but then layer in technology
5:15
and how technology
5:17
is changing and frankly,
5:19
that
5:20
the technology
5:21
changes much faster than we can build a
5:24
building.
5:26
So,
5:27
I can't say that building a building has
5:30
changed much,
5:31
you know, it takes a certain amount of
5:33
time to design it, to document it, and
5:36
to actually construct it.
5:38
And during that time,
5:40
for instance, we're we are a
5:44
we are in,
5:45
what, month 40 of a sixty six month
5:51
construction project
5:52
and we spent probably two, two and a
5:54
half years before that designing.
5:57
So during that time frame,
6:00
a lot can change in technology.
6:02
So the charge I was given is
6:05
make sure that you bring in the largest,
6:08
so to speak, pipe that you can
6:11
to allow for, you know, those gigabytes to
6:14
flow
6:15
and make sure that there's enough power
6:19
to
6:20
ensure
6:21
AI will work in the new building.
6:24
We're not sure what that technology is going
6:26
to be or how it's going to evolve,
6:28
but those are the things that that flexibility,
6:31
that adaptability
6:32
is what we really focused on.
6:35
And and what does that flexibility and adaptability
6:37
look like, particularly as we move towards this
6:39
period of time when there's so much of
6:41
these new power centers and AI centers, and
6:44
it seems so complicated to figure out what
6:46
the power design and the and the throughput's
6:48
gonna look like. And and how do you
6:50
sort of manage that kind of flexibility
6:52
Yeah. You know, without with also choosing a
6:54
direction.
6:55
Yeah. That's you know, and, again, that's that
6:58
was the challenge. And it's really about,
7:02
the connectivity to the Internet and how much
7:04
how many gigabytes
7:06
you can you can flow through your system,
7:08
how
7:09
you leverage wireless technology and that evolution.
7:12
But to your point about power, you know,
7:16
we looked at what a typical
7:20
academic health center,
7:23
what is the power per square foot
7:26
that we would normally see
7:29
and we doubled it.
7:31
So just to make sure that we would
7:33
have that power and we worked directly with
7:35
our local utility company to make sure that
7:38
we actually put in a new switchyard
7:41
that allows for that.
7:43
We talked about partnering with them to create
7:46
a microgrid in the future.
7:48
We looked at how solar is incorporated into
7:51
this, not that that necessarily
7:54
increases
7:55
our power
7:57
to the hospital, but how
8:00
can we heat and cool the building in
8:03
different ways that can be adapted over time.
8:06
We, we also looked at geothermal,
8:08
to be honest with you. But,
8:11
so the the power grid being the most
8:13
critical piece of this and then that connect
8:16
that connectivity
8:18
back to, to the Internet.
8:21
Fascinating. And and take a second on and
8:23
sort of when you look at this year,
8:25
2026,
8:27
you've got such a sprawling portfolio at IU
8:30
Health. What are you most focused on and
8:32
excited about it? And maybe you could tell
8:33
us a little bit about the size of
8:35
the portfolio and what's included in the in
8:37
the building portfolio at at IU. Sure. So,
8:40
you know, obviously, the project that we we
8:42
have going on downtown
8:44
in Indianapolis
8:46
apologize. So if you hear a helicopter in
8:49
the background, that's our,
8:51
our lifeline.
8:53
That's
8:54
free in either bringing or taking someone to
8:56
the academic health center here.
8:59
But, anyway,
9:01
this project alone is $4,290,000,000.
9:04
It sits on a 44 acre
9:06
piece of property. The hospital itself is 2,560,000.00
9:10
square feet. Overall,
9:12
we're building a little over 3.4
9:15
of new facilities, including the central utility plant,
9:18
all of those things. But that to your
9:20
point, that's only a part of our portfolio.
9:23
We are also building a new hospital in
9:25
Fort Wayne.
9:26
We're expanding our our facilities and cancer center
9:30
in Lafayette
9:31
and a new hospital in West Lafayette.
9:34
We're building,
9:36
a new patient tower on our North Hospital
9:39
in Carmel, just
9:41
just north of Indianapolis,
9:44
and we just opened a new expansion in,
9:47
in Fishers,
9:49
at, what used to be Saxony Hospital, now
9:52
is, Fishers Community Hospital, a new name, same
9:56
IU Health.
9:58
So, you know, we are
10:01
probably close to $8,000,000,000
10:04
in in per in construction and in planning,
10:08
over the next five years or so.
10:11
So,
10:12
very large portfolio, very strong appetite, but
10:16
we see that as, you know, we're the
10:18
largest healthcare provider
10:21
in the state.
10:22
We
10:24
are continuing to grow and expand
10:26
our reach,
10:28
and,
10:29
we're in demand,
10:31
and we're
10:34
really focused on
10:37
making Indiana one of the healthiest
10:39
states in the country. And so, in order
10:42
to do that, we're,
10:44
we're looking at how we can best provide
10:46
for
10:47
the people, the Hoosiers here in our state.
10:50
Thank you very, very much. Now did you
10:52
grow up in Wisconsin or Indiana, or where
10:55
did you grow up? I grew up in
10:57
Wisconsin. So, I, so I'm a badger,
11:01
displaced, I guess. But,
11:03
but yeah. So I've been, in Indiana since
11:06
2016.
11:08
And have you become an Indiana Hoosier fan,
11:11
particularly with your this year's football season, or
11:13
where do you stand on that?
11:16
Of course. You know,
11:18
it it's an amazing turnaround
11:21
for having
11:22
a program that at one point in time
11:24
was
11:25
the least winning to being the most winning.
11:28
And that's and in some ways, that's an
11:30
analogy
11:32
to the health of of those in Indiana.
11:34
Right now, we're one of the least healthiest
11:36
states in the country,
11:38
and, we're
11:40
incrementally
11:41
improving that through, you know, our focus on
11:45
on providing
11:46
the highest quality care,
11:48
to to those who live and work in
11:50
Indiana.
11:51
You know, one of the first projects that
11:54
I was involved with was at Riley Hospital
11:56
for Children, where we moved the the mother
11:59
baby program from Methodist Hospital there,
12:02
and IU Health
12:04
made a large investment in neonatologists
12:08
throughout the state
12:09
because
12:10
unfortunately at that time,
12:13
Indiana had
12:15
the highest
12:17
mortality rate for infant mortality rate in the
12:20
country, and we've changed that and that's improving
12:23
and continues to improve, and that's part of
12:25
that investment is bringing those specialists here to
12:29
this state. That's why we're building this new
12:31
hospital because we're looking to attract and retain,
12:34
frankly, the best and brightest.
12:36
And that investment
12:39
in in a facility that really is a
12:41
tool
12:42
to provide the best care possible,
12:45
to educate the next generation
12:47
of health care providers,
12:49
and to
12:51
to really,
12:52
partner with, with the school of medicine here
12:55
at Indiana University and
12:57
find cures,
13:00
and explore new ways to
13:02
provide that care to our patients
13:05
is key.
13:06
And that's what makes me really proud to
13:08
be part of this project, because it's that
13:11
leading edge and that forethought of how can
13:14
we change that trajectory of health in our
13:17
state
13:18
and make make it one of the healthiest
13:20
in the country.
13:22
We're on that journey.
13:24
No. And fantastic. And talk a bit about
13:27
IU Health because IU Health is a remarkably
13:29
well run health system.
13:31
Talk a little bit about IU Health and
13:33
what brought you there and your pride and
13:35
how good of leadership there is at IU
13:36
Health.
13:37
Yeah. You know, I I,
13:39
I was
13:41
fortunate enough to have worked with Dennis Murphy,
13:43
who's the CEO at Northwestern. He was the
13:46
COO there.
13:48
And so,
13:50
so I knew
13:52
he had a commitment
13:54
when when
13:56
when IU
13:57
Health talks about
13:59
leading the way, creating the healthiest state in
14:02
the country,
14:03
exploring
14:05
new and innovative ways for delivering care. I
14:07
know those are all things that that is
14:10
near and dear to Dennis' heart
14:13
and he has brought together a leadership team
14:15
that,
14:16
that's, I believe, second to none,
14:19
and so I'm very proud to be part
14:21
of that leadership team and changing that trajectory
14:24
here,
14:25
and partnering with the school of medicine
14:28
to do
14:29
that leading
14:31
edge research.
14:33
You know, we have Simon Cancer Center, which
14:37
is one of the comprehensive
14:40
cancer centers
14:42
in the country.
14:44
We are leading in neurosciences
14:47
in Alzheimer's research.
14:50
You know, we're one of the, I think,
14:52
top, top 10 research
14:55
on Alzheimer's in the country.
14:59
We have,
15:00
so that's an extremely strong program
15:03
and we're building our cardiology program now. So
15:06
those those are really key. And, obviously, you
15:09
know, Riley Hospital for Children has always been,
15:12
one of the top pediatric hospitals in in
15:15
the country as well.
15:17
So
15:18
Fantastic. And let let me ask you a
15:19
question. Did you did you
15:22
with the Dean Harrison era or the Gary
15:25
Mecklenburg era at Northwestern
15:27
or some of both?
15:30
So, you know, when I was,
15:32
when I was practicing
15:34
architecture and planning,
15:36
Northwestern
15:37
was, was a client. So I was part
15:40
of the the master plan that was finished
15:42
in 2006
15:44
that really, expanded the campus
15:48
the downtown campus, as well as looked at,
15:52
some of the other,
15:54
like, Lake Forest
15:56
and,
15:57
and out in DuPage County and and some
15:59
of those other things. So so I was
16:01
familiar, and Gary was
16:03
the CEO at that time,
16:06
as, as was, you know,
16:10
Pete McKenna was the CFO,
16:12
and,
16:14
Dennis was the COO.
16:16
So
16:17
Gary had a very strong team with Kathy
16:19
Marie and and others.
16:21
And so then Dean,
16:24
Harrison,
16:26
who was
16:27
he really took over, and that's who I
16:30
worked under,
16:31
while I was there.
16:33
Well, fantastic. And and talk about this because
16:36
there must have been education because when you
16:37
were at Northwestern or worked with Northwestern,
16:40
they made some huge bets.
16:42
And at the time, some of us thought
16:44
building a billion dollar hospital or multibillion dollar
16:46
hospital
16:47
was crazy,
16:48
and it turned out to be a really
16:50
good bet and a really smart bet.
16:53
Any lessons from some of that that's that
16:55
you've then been able to use in the
16:56
last decade at at IU Health?
16:59
Yeah. I would say that,
17:01
yeah, the the mistake by the lake. Right?
17:03
So that was that was what was coined,
17:06
by one of our competitors, I believe.
17:09
And,
17:10
it it proved not to be a mistake
17:12
at all to your point. It
17:15
really propelled Northwestern,
17:17
from where they were to where they are
17:19
today, you know, as one of the now
17:21
world hospitals,
17:22
by US News and World Report.
17:24
And, yeah, I I would say that investments
17:27
is really what's happening here. We're we're investing
17:30
in the future, and we're we know that
17:32
academic
17:33
medicine is going to remain strong.
17:36
It's, it's something that, others,
17:39
you know, the price of entry
17:41
to academic medicine is pretty high.
17:44
And so,
17:45
keeping that,
17:47
that portfolio strong and keeping the facilities,
17:51
as strong,
17:53
is is key to,
17:55
to attracting and retaining the talent that that's
17:58
out there.
17:59
So that investment is huge. And I would
18:01
say one of the things that Cary Law
18:03
said is as we were doing that master
18:06
plan when Lurie Children's or
18:10
Children's Memorial was thinking about moving to one
18:13
of the campuses in this town.
18:15
And as we were doing the master plan,
18:17
that was always in the background, and Gary's
18:20
and I'll always remember this,
18:24
his advice was,
18:26
don't worry about what you don't know.
18:29
Finish your work.
18:31
When
18:32
Children's Memorial decides Lurie Children's decides to come
18:36
here, we'll adjust.
18:38
And that's exactly what we that's exactly what
18:41
we did, and it's been really good advice,
18:44
and that's one of the things that I
18:45
brought I brought here.
18:48
Really remarkable. Now one more question. You've had
18:51
this great career,
18:53
really, right in the middle of your passion
18:55
in a place that's had huge impact over
18:57
the last several decades
18:58
and at great systems.
19:00
Any advice that you would give to emerging
19:02
leaders trying to have
19:04
impactful and enjoyable careers?
19:07
Yeah. I really need, probably
19:10
lead with purpose.
19:11
You know, really
19:12
anchor decisions and
19:15
and clear guiding principles and follow your passion.
19:18
I mean, one of the things that I
19:20
to your point, I'm I'm a,
19:22
I'm really
19:24
passionate about providing
19:26
the best care possible.
19:29
I mean, I'm not a care I am
19:31
not a caregiver.
19:32
However,
19:33
I can improve
19:35
the facility that that caregiver
19:38
provides that care
19:39
and give that caregiver the best tool possible
19:43
so that they can provide the best care
19:45
possible
19:46
to that patient and make a difference there.
19:49
And and so
19:51
follow your passion, lead with purpose,
19:53
anchor your decisions and guiding principles,
19:57
and stay true to those.
19:59
That's that's what I would say is is,
20:02
my advice to those,
20:05
those evolving leaders.
20:07
No. Yeah. I I absolutely love it. And
20:09
and and, James, you've had this magnificent, magnificent
20:11
leadership career. I mean, just fantastic. James Mladecki,
20:15
thank you so much for joining us on
20:17
the Becker's Healthcare podcast. What a remarkable career
20:20
and what remarkable things IU Health is doing.
20:22
Just fantastic. Thank you. Thank you very much.