Swift Healthcare

Swift Healthcare video podcast explores the intersection of Healthcare and Leadership with conversations to engage, restore, & transform leaders, providers, & organizations.

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Tuesday Mar 30, 2021

In this episode, we discuss the ethics of mandating people to receive the COVID vaccine (vaccine  mandate) and whether this is prudent. Nothing is black and white in this episode and our guest is Charles E. Binkley, M.D., F.A.C.S., Director of Bioethics at the Markkula Center for Applied Ethics at Santa Clara University.
Dr. Charles Binkley, an experienced cancer surgeon, bioethicist, and health care quality leader, directs the bioethics program at the Markkula Center. Dr. Binkley attended Georgetown University School of Medicine and completed his surgery training at the University of Michigan where he was awarded an NIH fellowship in pancreatic cancer research. Dr. Binkley has served on the Committee on Ethical, Legal, and Judicial Affairs of the California Medical Association, as well as on the Board of Directors of the San Francisco Medical Society.
Dr. Binkley is a Fellow of the American College of Surgeons and also directs the Health Care Ethics Internship and Honzel Fellowship in Health Care Ethics at Santa Clara University. His research is focused on the ethical application of AI clinical decision support systems as well as surgical ethics. His research and writings have been published in Cancer Research, Annals of Surgery, Journal of the American College of Surgeons, STAT News, and America Magazine.
Dr. Charles Binkley, MD, FACS links:
https://www.linkedin.com/in/charlesbinkley/
https://www.scu.edu/ethics/about-the-center/people/charles-binkley/
Twitter: @CharlesBinkley
 
Music Credit:
Jason Shaw from www.Audionautix.com 
 
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Patrick Swift, PhD, MBA, FACHE: [00:00:00] Folks, welcome to another episode of the Swift healthcare video podcast.
[00:00:03] I'm Patrick Swift. I'm delighted that you're here and I have a wonderful guest for you for this episode, Dr. Charles Binkley, Charles. Welcome to the show.
[00:00:11] Charles Binkley, MD, FACS: [00:00:11] Thank you, Patrick. It's a real pleasure to be here.
[00:00:14] Patrick Swift, PhD, MBA, FACHE: [00:00:14] Yes, I'm delighted. And, and Charles, Dr. Brinkley is, is, uh, based out of currently California. So you can feel the warmth for those of you watching this episode can feel the warmth. And if you're listening, I just want to encourage you to feel that California warmth and those rays. So Dr. Charles Binkley is.
[00:00:32] Listen to this. He's an experienced cancer surgeon, bioethicist and healthcare quality leader. He directs the bioethics program at the Markkula center at Santa Clara university, the Jesuit university of Santa Clara of Jesuit university of the silicone Valley. I'm happy to throw that in there cause I love the Jesuits.
[00:00:50]Dr. Binkley attended Georgetown university school of medicine, go G-town. And completed a surgery training at the university of Michigan awarded an NIH fellowship in pancreatic cancer research. Do you hear the theme here of ethics and care? Dr. Brinkley has served on the committee on ethical, legal and judicial affairs of the California medical association, as well as the board of directors of the San Francisco medical society.
[00:01:14] He's a fellow of the American college of healthcare surgeons. He also directs. The healthcare ethics, internship, and Honzel fellowship in healthcare ethics at Santa Clara university. Dr. Brinkley, thank you so much for being on the show.
[00:01:27] Charles Binkley, MD, FACS: [00:01:27] Patrick. It really is a pleasure to be with you this afternoon. And it is 70 and sunny out here in San Francisco. You can see the sun coming through the window here, but after having spent seven long, cold years in Ann Arbor, I feel like I deserve at least a couple of decades of California sunshine.
[00:01:43] Patrick Swift, PhD, MBA, FACHE: [00:01:43] Absolutely. That is good karma. That is a, the universe coming through and I can feel that warm. So thank you. I'm broadcasting out of Maplewood, New Jersey. We're still hoping for that. Uh, in the New York city tri-state area, we're still hoping for that warm weather. So, uh, I'm glad you're here, Charles. And, and we're talking in this episode about ethics of vaccine mandates with Dr.
[00:02:04] Charles Binkley MD. So. Let's jump right into this. And how did you get into this work overall?
[00:02:11]Charles Binkley, MD, FACS: [00:02:11] Well, my involvement with ethics really spans my entire career and it's taken different forms from, , chairing clinical ethics, consult committees and, and major hospitals. , to working on ethics, education, you know, how do you teach, , healthcare providers, ethical behavior? How do you instill in them? , the things that we profess and that patients expect from us.
[00:02:32]and then also, how do you create policies that guide, , healthcare professionals, when they face ethical dilemmas? And so I haven't been involved with it in my entire life. And also thinking about, you know, some of their specific ethical issues that cancer patients face that physicians caring for cancer patients face, , that surgeons face.
[00:02:51] You know, I used the opportunity, , to segue into a different phase of my career where I'm dedicating most of my time to, , ethics, to teaching. , to writing and research and then also doing a clinical ethics consultation in healthcare quality consultation. So that's really, you know, my path, , to my current position.
[00:03:11] Patrick Swift, PhD, MBA, FACHE: [00:03:11] and I love the path that this, , this thread that you have shared is from the clinical care to the surgical care, to then integrating that into what we do and, and supporting healthcare providers and leaders and being ethical in what we do. So help me unpack ethics because, , you know, I've got a PhD.
[00:03:30] People argue as stands for piled higher and deeper (LOL). Um, when we talk about ethics, , it means different things to different people. So, , could you share with the audience what you mean by ethics?
[00:03:42] Charles Binkley, MD, FACS: [00:03:42] Yeah, absolutely. And it's a great question. So I always start from the idea of a profession. So, , healthcare is considered a profession, whether that be as a healthcare provider, a healthcare leader, a healthcare executive. It's considered a profession. And so a profession begins by an assumption. There are things to which members of that profession, profess , and things that the community that the public can expect of members of that profession.
[00:04:09]And so what are the things that the community of healthcare providers, the healthcare leaders profess. So first of all, it's to do good and avoid harm, and that's sort of the cornerstone of the profession. So based on that profession, , then you can distill certain ethics. And so again, the ethical translation of that is that, you know, we will prioritize our patients that we will do good to them, and the tools of medicine can be used for good and for harm, you know, everything that we do as a surgeon, I was, you know, acutely aware of that.
[00:04:36] Every time I wilted. A scalpel, it can, can heal and it fell so harm. And so what we profess is that these tools that we've inherited will use for good and avoid harm to the best of our abilities. And also in that is that we will not necessarily define. Benefit and harm by our value system, but by the patient's value system.
[00:04:59]And we'll, we'll come to a place where we use the tools of our training and our experience, our professional responsibility, but also really listen to the patients and engage them and their decision-making. And so that it's, it's not, it's not only joint. , but it really is. We each guide the other to come to what is right in that situation.
[00:05:18] And then, you know, we oftentimes think of justices, you know, am I treating the patient in front of me the same way that I treated the last patient that I saw and the next patient that I'll see. But I really think that, that our challenge as healthcare providers is to think about justice much more broadly. And it's not only, it's not just about the individual patient in front of you, but our all patients having the same level of access to care that I'm providing. And I think about this, particularly in the context of cancer care and right now in the context of vaccinations for COVID, but you know, to think about cancer care, right.
[00:05:50] You know, are we concentrating high quality cancer care only in large academic medical facilities and taking it away from public hospitals, , in an attempt to improve care. So the idea is, is that healthcare quality, you know, the more you do, the more you concentrate, the more you have different disciplines and interdisciplinary discourse, a higher quality of the care is, but as you, as you move some of those resources.
[00:06:13] Away from, , public hospitals away from rural hospitals, you may actually be cutting off your nose to spite your face. So the very patients who need that may not have access to it. So the intentions again are based around beneficence non-maleficence, , but you may not really be considering autonomy and justice in that equation.
[00:06:32]Patrick Swift, PhD, MBA, FACHE: [00:06:32] I appreciate the thread of what you spoke to about. What we profess as professionals. It connotes what we profess in our faith and our belief system, which drives us and the, the profession itself. And then the, the coming together of the heart and mind about recognizing a clinician, a physician, a therapist may have a different set of ethics and to acknowledge that , those that we take care of may have a different set.
[00:07:00] Charles Binkley, MD, FACS: [00:07:00] Oh,
[00:07:00] Patrick Swift, PhD, MBA, FACHE: [00:07:00] do we come together? I love that point. I mean, I love all you said, but I, that stands out to me as the, the heart of what we do, because we are human beings caring for human beings. And if we're truly being that kind of clinician leader, whatever it may be, we're acknowledging the humanity of the other person.
[00:07:18] Charles Binkley, MD, FACS: [00:07:18] That's absolutely right. And that's what binds us all together, but it becomes tricky is when those of us professing this. Um, really incorporates other, other people, other entities, other businesses that don't have that expectation. So for instance, you know, healthcare and technology now are forming lots of relationships and technology doesn't necessarily have that professional or that societal obligation that healthcare does to do good and avoid harm.
[00:07:46] So we, we have to be very excited. Listen about these relationships. Yeah, we have to be very explicit. , the other thing that's happening, , is how this idea of justice. , is effecting vaccine rollout and, , lots of places. , there's this balance between, you know, how stringent are you, how much do you require people to prove their age or proved their profession or proved they're in their correct here?
[00:08:09] Which disincentivizes people. So had you read there, let a few bad players in. , or create a very rigid system that keeps some really good people out. Particularly people who may be undocumented, people who may be elderly and not able to, , produce the sorts of documents they need in order to get vaccinated.
[00:08:27] So in my way of thinking about it, you're always going to have the people who tried to cut the line. We learned that in kindergarten. Right. But what you really want to do is make sure you lift up those people who may not ordinarily have access and make sure that they get in, and then they're also, , have their place in that line.
[00:08:45] Patrick Swift, PhD, MBA, FACHE: [00:08:45] one of my other guests on the show has been Dr. Steve and Rumery. And we had an episode on restorative leadership and Dr. Rumery is helping supporting the one campaign and, , equity and distribution of the vaccine. And you're touching on the fact that there's that human nature, that there's always the.
[00:09:03] Person who. Attempts to jump in line or who does jump in line. And, , what's coming up for me is do we base our rules on fear that there may be a jerk or do we base our rules on add my arm DEI. Gloriam helping. To the greatest glory to the greatest good are rules-based on helping the most and doing the most good or our rules based on fear to make sure someone can't edge the system.
[00:09:28] It's it's uh, this is delicious. What you're saying is, and I want to talk about the, the, the, the ethics of vaccine mandates too. And so how does that fit in with this to Dr. Brinkley?
[00:09:38] Charles Binkley, MD, FACS: [00:09:38] So the idea behind vaccine mandates (vaccine mandate) is it really is the most efficient way to reopen certain parts of, , society, , certain benefits that society has come to expect, , in a way that is safe. , and that protects everyone particularly the most vulnerable. So th th just going back to the vaccines, you know, part of getting a vaccine is not just to protect yourself, but it's to protect the rest of the society is a reciprocal relationship.
[00:10:04] So I do this not only for my good, but also for your good, and so, There are certain sectors of society that simply can't always engage in risk reducing activities. So let's take, for instance, getting on an airplane and , , you just, you can't socially distance. There are medical emergencies on airplanes that require close contact between flight attendants.
[00:10:27], and sometimes passengers with each other. , these aren't always anticipated there. They're usually, , surprises that happen. Just the flight attendants in their job. Can't always socially distance, between passengers, , mask mandates, , flight attendants have been forced in this really uncomfortable position of.
[00:10:47] Performing the job of police in the air and making sure that people have on their masks and, and the, the, the airline industry has been decimated. In terms of its income. You know, people are afraid to fly the CDC, you know, putting out warnings about flying about travel. And so people aren't flying. So in my mind, the most efficient way for the airline industry.
[00:11:11] To both meet its ethical obligation to ensure the safety of passengers and its employees, because really that's, that's the foundational ethical obligation of airlines. That's why we cancel flights. When the, when it's, when there are tornadoes, there's this? Why, if the engine isn't forming performing well, we cancel flights.
[00:11:30]So safety is the cornerstone of the airline industry. And what better way to ensure the safety of its employees and the passengers. Then to mandate that they receive a COVID 19 vaccine and there are some legitimate exemptions, , for instance, you know, there's, we haven't completely proven the safety of the vaccine and pregnant persons.
[00:11:50], and so there would need to be a conversation there. , some people may have, , some objections to the vaccines, , on religious grounds. However, the Catholic church. , one of the most, , ardent critics of abortion has been very clear that all of the vaccines are morally permissible and has even gone so far as to say that Catholics have a moral obligation to receive the vaccine as an act of charity.
[00:12:13]but, but, but it's not reasonable for passengers to claim autonomy. So you can claim autonomy when it comes to making healthcare decisions with your healthcare professional, but airlines have no obligation to respect an individual's autonomy. And in fact, you lose some of your autonomy when the door's closed, you can't get up and walk around where you want to.
[00:12:33] You can't smoke when you want to, you can't sit where you want to. So. If someone doesn't want to get the vaccine, that's fine. There's no ethical loss from not flying you. There's no obligation to provide service to people who don't want to cooperate with the rules.
[00:12:49]Patrick Swift, PhD, MBA, FACHE: [00:12:49] I love it and being, gosh, you, the way you put this together is so eloquent to acknowledge the, the greater whole of us. Right. That,
[00:13:01]professionals healthcare professionals, non-healthcare professionals that are stridently adamant that they have rights. And this is an oppression of the rights and you make a beautiful point that enjoy your rights. Just don't get on a plane. If you're going to be a risk to others. And the notion that there's the, the greater, the greater whole of us.
[00:13:19]
[00:13:19] Charles Binkley, MD, FACS: [00:13:19] Exactly. And I'd rather incentivize people to get vaccines than punishing them for not. Right. And, and I, I would probably have greater concern if the government came out and mandated vaccines (vaccine mandate), because then how do you enforce that? What do you do to people who don't get vaccines instead, incentivize them and say, so you want to fly great.
[00:13:36]This is what you need to do. You need to be able to show the true, safe to fly and the way that you do that as a, to show proof of your vaccination. I think there are other sectors in which it would be, uh, Ethical. And in some ways, , desirable, , to require vaccines. I published an article recently looking at churches and saying that, you know, churches have really, , they've, they've raised a ruckus to say, we want people to be present.
[00:14:03] And people have said, I want to be able to worship in person. And I think those are admirable goals, but it also has to be done safely. You don't want to kill people in the process. , and so one way to reopen churches, , safely and efficiently is to, , essentially require the church goers be vaccinated.
[00:14:20] You know, I think about my own family, , we're uh, going to be visiting my in-laws. We haven't seen them. We've seen them distanced several times that we haven't actually. Then with them physically to hug them, , to sit at a table with them in a, over a year. And so we're, we're going to hit that point where we've all been vaccinated in about three weeks and we've had two weeks after our last vaccinations.
[00:14:43]And we're really looking forward to being with them in a way that's safe for everyone. Uh, and that we don't have to, to worry quite as much, , about, , getting infected manufacturing, someone else.
[00:14:55] Patrick Swift, PhD, MBA, FACHE: [00:14:55] Yeah. Yeah. And thinking about again, the greater good, and that's an act of charity as an act of love that you're going through this vaccine in order to not only take care of oneself, but also to take care of others. So I love, I love that example. Do you, um, please go ahead.
[00:15:11] Charles Binkley, MD, FACS: [00:15:11] no, it's also, so we can take care of other people too, because if we get sick, it's not just our own illness, but it's also the people who depend on us for care and so many different ways.
[00:15:21] Patrick Swift, PhD, MBA, FACHE: [00:15:21] Yeah. Beautiful. So, Dr. Brinkley, what would the take home message be for a listener as we've covered a lot of ground, different shades and implications about this? What's the nugget of the take home message here.
[00:15:33] Charles Binkley, MD, FACS: [00:15:33] Yeah. So I really get at this idea that you don't just learn ethics once and assume that they're always going to be there.
[00:15:41] Patrick Swift, PhD, MBA, FACHE: [00:15:41] It's not a one and done.
[00:15:43] Charles Binkley, MD, FACS: [00:15:43] it's not a one and done, and ethics are also not binary, right? You're very seldom, either ethical or unethical. They're all shades of gray. One of the, one of the most alarming things somebody ever told me was, uh, was another physician saying, well, I consider myself an ethical person.
[00:15:57] Well, that's, that's problematic in and of itself. If you're so confident and confident in your, your ethicalness or your, your ability to be ethical, you know, it comes from a place of humility, always asking, always reviewing. Now wondering if we've done the right thing and not to torture ourselves with it, but not to take it for granted either.
[00:16:18] And to be intentional about ethics. And it's going to, it's going to vary from person to person situation, to situation. And there's not a book that you can go to. And it's really about in many ways in my mind, , ongoing formation of the conscience, uh, in a way is a virtue based ethic where you try to not only be.
[00:16:39] And ethical physician and ethical nurse and ethical, uh, neuropsychologist, but an ethical human being who happens to be a physician, a nurse, a neuropsychologist.
[00:16:49] Patrick Swift, PhD, MBA, FACHE: [00:16:49] love it. It's good to reminds me of Teilhard de Chardin's famous quote. We're not human beings having spiritual experiences, but spiritual beings, having human experiences and, and you speak to living in the gray and recognizing the gray. The ethics is not. Binary. It's not an either or it's not black and white, but there are gray areas that we have to navigate in the work you've done in the ethics committees and the work I've done as part of ethics committees in hospitals, in a leadership position and a clinical care position.
[00:17:19]There are many gray areas that we have to navigate, and the key is to hold up the patient, the care, and also doing it ethically in the way that we're drained.
[00:17:30] Charles Binkley, MD, FACS: [00:17:30] Oh, absolutely. And that, that gray area can be both life taking and life giving. And when our gray area, when we get punished for being in the gray area, when we, , are disincentivized for asking questions and for wondering. Uh, as a clinician, as a healthcare leader, that's where physician burnout comes from is the loneliness of the gray area, because we don't like the gray area.
[00:17:52] It, it doesn't, it's not, it doesn't generate funds. It doesn't create good quality scores. , and it doesn't perhaps make us look good in front of our peers, but we all face that gray area. And to be able to sort of share that gray area and to be able to say, gosh, we're all in this together. Let me help you.
[00:18:08] And you will help me in turn. I really think that that, that gray area is. The sink for physician happiness, that a lot of professional fulfillment is sucked up by the loneliness of that gray area produces.
[00:18:20] Patrick Swift, PhD, MBA, FACHE: [00:18:20] did you say sink? Like,
[00:18:22] Charles Binkley, MD, FACS: [00:18:22] It seems like it pulls it out of you. Yeah. Like a sink hole.
[00:18:26] Patrick Swift, PhD, MBA, FACHE: [00:18:26] Um, so it's a powerful image and, and, , one that speaks to , the call to. Do something actively to not be drawn into that sink hole, , to, to be able to lift, lift yourself up and in. So doing lift others when we're burnout at whether we're healthcare leaders, providers, um, , supporters, caregivers of a loved, one of a, of a healthcare professional.
[00:18:49]This is something that healthcare is a team sport and we need to lift each other up.
[00:18:54] Charles Binkley, MD, FACS: [00:18:54] Absolutely. Absolutely. Yeah.
[00:18:57] Patrick Swift, PhD, MBA, FACHE: [00:18:57] So I'd love to then ask you my, um, it looked like you were about to say something, so it was, you're going to add something to that.
[00:19:03] Charles Binkley, MD, FACS: [00:19:03] Well, it's just, it's, it's a matter of, yeah, exactly. It's lifting each other up, uh, so that we can all help each other be the best possible selves that we can be.
[00:19:13] Patrick Swift, PhD, MBA, FACHE: [00:19:13] Um, Hmm. I love that because it speaks to when we are, we are being our best possible selves when we are lifting each other up and, and by so doing, by reaching out. We are becoming better people and healthcare professionals. I was speaking with Dr. Dike Drummond on another episode of the show and talking about the culture in healthcare, where, , there's pressure to work autonomously independently, have no faults.
[00:19:36]And, , it, it dehumanizes the physician experience. It dehumanizes a healthcare person experience that we actually need to ask for help. We need to acknowledge our weaknesses and, and seek support. And so I'm certain. , by people hearing your voice and finding comfort in what you have to share with us, Dr.
[00:19:53] Brinkley, that people are being uplifted and I'm grateful for that. And that leads me to my favorite question, which is if you were standing at the top of the world and you for a brief moment, had the attention of all the healthcare folks on the whole planet for a brief moment, what would you say to them?
[00:20:09] Charles Binkley, MD, FACS: [00:20:09] Gosh, you know, it would really have something to do with, um, relax, trust yourself, trust your patients. , listen to your inner voice, , and to trust that.
[00:20:22] Patrick Swift, PhD, MBA, FACHE: [00:20:22] Hmm. Hmm. We're talking about ethics and you're talking about our conscience. And here you are talking about listening to your voice, listening to the heart, listening to the. to that voice and trusting, I love, , the notion of trust. And just by you saying that it relaxes me, I can take a deeper breath.
[00:20:40]The being reminded to trust, trust, oneself, trust, trust others, and we can do this together. So thank you, Dr. Brinkley. And if folks are interested in following up, I know there's some amazing resources. So all going through out there, there's amazing resources at the Markkula center. Uh, but how can folks follow up with you?
[00:20:57] Charles Binkley, MD, FACS: [00:20:57] So, , you can follow me on Twitter. It's at Charles Binkley. , you can also connect with me on LinkedIn, , Charles Binkley, , and I can through either source, , you can also visit the Mark listeners website and learn more about the work of, , the bioethics, , division at the Marcus center and at Santa Clara university.
[00:21:15] Patrick Swift, PhD, MBA, FACHE: [00:21:15] awesome. Well, I will include that in the show notes and, , certainly I encourage folks to follow, uh, Dr. Brinkley on Twitter, LinkedIn, and, , the links will be on the episode show notes as well. So Dr. Brinkley, thank you so much for being part of the show. I'm deeply grateful for your heart and wisdom, and I pray that listeners, , takeaway some support , , comfort and compassion, courage, joy, and hope.
[00:21:37] In, uh, in this message, , in this episode. So thank you.
[00:21:40] Charles Binkley, MD, FACS: [00:21:40] Thank you, Patrick. It's been a real pleasure to be with you. And now we're heading to the beach for the afternoon.
[00:21:44] Patrick Swift, PhD, MBA, FACHE: [00:21:44] Outstanding. All right. Thank you so much, artistically.
[00:21:49] Charles Binkley, MD, FACS: [00:21:49] You're welcome. Be well.
[00:21:51]
Ethics of Vaccine Mandates w/ Charles Binkley, MD, FACS
Vaccine Mandate podcast episode
 

Tuesday Mar 16, 2021

In this episode, we discuss what health equity is all about, what we can do to advance patient and family engagement, and how these issues matter to us all when it gets right down to it.
Our guest is Kellie Goodson, MS, CPXP, a thought leader in the areas of person, or patient and family engagement (PFE) and equity in health care quality and safety improvement. She has led a multi-year analysis of hospitals leveraging and deploying PFE in quality and safety improvement that demonstrated a correlation between high levels of PFE and improvements in patient outcomes, specifically lower rates of 30-day readmissions and falls with injury. She has worked with multiple health systems to improve patient outcomes using quality improvement science through the lens of health disparities identification and resolution.
Kellie co-led national Affinity Groups for the topics of PFE and health equity for the Centers for Medicare and Medicaid Services and has served on National Quality Forum committees, including the National Quality Partners Action Team to Co-Design Patient-Centered Health Systems.
Kellie received her Bachelors of Science in Business from the University of New Hampshire and her Masters of Science in Integrated Health Care Management from Western Governors University. She also received her Certified Patient Experience Professional (CPXP) designation.
Kellie Goodson, MS, CPXP on LinkedIn:
https://www.linkedin.com/in/kellie-goodson-ms-cpxp/
On Twitter @kac0102
Music Credit:
Jason Shaw from www.Audionautix.com 
 
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to learn from audio interviews a way to participate.  Please enjoy!
Patrick Swift PhD, MBA, FACHE: [00:00:00] Welcome folks to the Swift healthcare video podcast. I'm Patrick Swift. And I want to thank you for dialing in for joining us. I have a special guest Kelly Goodson for the show. Kelly. Welcome to the show.
[00:00:11] Kellie Goodson, MS, CPXP: [00:00:11] Great. Thanks to be here with you today, Patrick.
[00:00:13]Patrick Swift PhD, MBA, FACHE: [00:00:13] Absolutely. I think we're going to have, okay. Fantastic show. And let me read you folks. Uh, Kelly's bio here. Very impressive. Uh, person Kelly is a thought leader in the areas of person, patient, and family engagement and equity. In healthcare quality and safety improvement, she has led a multi-year analysis of hospitals, leveraging and deploying patient family engagement in quality and safety improvement.
[00:00:36] She has worked with multiple health systems to improve patient outcomes, using quality improvement science through the lens of health, disparities, identification, and resolution. Let's not just identify it, but let's find the solution to it as well. Kelly has Cola and listened to this. Kelly has co-led national affinity groups.
[00:00:53] For the topics on the topics of patient family engagement and health equity, for who, the centers for Medicare and Medicaid services. I think you've heard of them and is deployed on the Nash has served on the national quality forum committee, including the national quality partners action team to co-design patient-centered health systems.
[00:01:12]Kelly, welcome to the show. I'm delighted you're here. And what are we talking about here? Folks? We're talking about patient family engagement. We're talking about health equity and you, and what that means is that this topic relates to all of us. This isn't just, um, a sub. A component with them. What we do with healthcare is all of us, whether we're in finance, whether you are in environmental services, cleaning, helping, cleaning the floor, whether you're in a physician, caring for patients, whether you're a CEO, I'm a CEO has gone undercover boss and I have, I've helped clean the floors and wiped down toilets and beds.
[00:01:47] This is all of us together. And the work that we do right. So I'm in the show. Kelly, we're going to talk about a lot of incredible stuff. And I want to ask you also just the top of the show. What are you up to these days? You've done so much.
[00:02:00] Kellie Goodson, MS, CPXP: [00:02:00] Yeah, thanks, Patrick. Uh, currently I'm working at Visiant, which is a, , member owned member driven healthcare performance company. We've got not-for-profit academic medical centers and community-based hospitals across the country. I've also started partnering with a new startup called diversity crew.
[00:02:20], and that's a consortium of passionate people, really wanting to help improve diversity, equity and inclusion, not only in healthcare, but in, in. All industries. And I also work with a company called ATW health solutions. It's a consulting company out of Chicago. Again, working in that patient engagement and health equity space.
[00:02:43] Patrick Swift PhD, MBA, FACHE: [00:02:43] excellent. Well, shout out to all those companies and, and just kudos for being part of all that. And we're, we're, we're taking a look at patient family engagement and health equity. We could talk about that for hours, right? But let's break that down for the purpose of the show and just talk about the tools and, and I know there are two tools that you're using this work.
[00:03:02] Can you tell us about that?
[00:03:04] Kellie Goodson, MS, CPXP: [00:03:04] Yeah. So I really focus on how to use patient and family engagement as well as health equity in your quality improvement efforts. So, you know, let's start with patient and family engagement. It's really, it's known. Throughout the industry that when an individual patient is activated and engaged and educated about their own health care, that they get better outcomes.
[00:03:30] Um, this has been studied for decades and, uh, I just want to mention Dr. Judy Hibbard who created, uh, what she called the PAC patient activation measure or Pam tool that actually she created.
[00:03:42] Patrick Swift PhD, MBA, FACHE: [00:03:42] healthcare without another acronym.
[00:03:44] Kellie Goodson, MS, CPXP: [00:03:44] know, right. Uh, but this patient activation measure really brought to light that patients are at different levels, uh, of their own, you know, knowledge, education, confidence in how to care for themselves.
[00:03:58] So, , Dr. Hebert came up with four levels of patient activation, you know, starting from sort of that traditional, , passive, , you know, Patient that really just receives healthcare. Just, you know, it's more of that one way street, they just receive the information , they do their best, but they don't really have the confidence to care for themselves.
[00:04:16]And then it, you know, it goes all the way up to level four, the highest level where. They're their own advocate and they are really, um, understand their condition. They, they advocate for themselves. They're looking for the best, , you know, medications and procedures and solutions for themselves. So this, this, , patient activation concept that Dr.
[00:04:38] Hibbard really brought out is one of the most researched and most studied, um, patient engagement tools. So it's, it's really brought to light how. Outcomes can be improved when we activate and engage our patients.
[00:04:53] Patrick Swift PhD, MBA, FACHE: [00:04:53] And that's so critical Kelly, because it reminds me of a, a gentleman I took care of in the two thousands, diagnosed with my Justina and gravis on, on a neuro rehabilitation unit. And when I first met him black gentleman in his thirties, and when I engaged him, I asked him how he was doing. And, and w w what are we doing?
[00:05:16] What are you doing here? How can we help you to get his input and his own words? And he said something that stuck with me. He said, what's the point in talking with you about this? Because no one really listens. And he had been misdiagnosed, poorly assessed and gone through a arduous, horrible journey of not.
[00:05:35] Being properly assessed and then treated and had been completely disempowered and stuff. My focus when I heard that, um, was to be his best friend, to engage, to get his story, to prop him up, uh, to be engaged in empowered. And what you're describing is these four levels in which the. One person is the least engaged and there is a bias I think we have of, well, if the patient is not really engaged and they must not really care about their health, and there is so much we can do. To engage our patients and also engage our colleagues to be part of this journey. So this gets to, I just, I love it. I love that you started with that and thank you for, uh, tickling my memory from, from 20 odd years ago, uh, , of an patient I was caring for, because this is about engagement.
[00:06:22] When we engage people. There are better outcomes. There's better. Self-esteem, there's better health. There's better quite frankly, joy and heart in what we do in this dyad, this collaboration with, with our patients and with each other.
[00:06:34] So let's switch gears, , to health equity and, , how can it be a tool for quality improvement?
[00:06:41] Kellie Goodson, MS, CPXP: [00:06:41] Well, let me, I'm going to ask you a question. I'm going to have you put your old CEO hospital's CEO hat on and
[00:06:47] Patrick Swift PhD, MBA, FACHE: [00:06:47] Oh, I got a hustle here. Okay. All right.
[00:06:50] Kellie Goodson, MS, CPXP: [00:06:50] So what would you say if I told you I could find, uh, the patients. In your hospital that have, that are in the highest readmitted let's use readmissions, for example, highest readmitted patients.
[00:07:03]And within that group, I can tell you exactly, , the subcategories of patients that are highest. Readmits to the hospital, , and really pinpoint who those groups are for you, so that you can, you know, shift your resources and shift your focus to help those patients not be readmitted and really reduce your, your readmissions overall.
[00:07:30] Would, would you be interested in that?
[00:07:32] Patrick Swift PhD, MBA, FACHE: [00:07:32] absolutely. And here's why. On many levels. And I, if I'm putting on that CEO hat, I'm going to put on my CEO hat, I'm not going to give the, the, the, the, the standard answer. Um, the standard answer I think, would be about, uh, well, I'll just speak for myself. Um, this is about, it is about safety.
[00:07:53] It's about quality. It's about the patient experience is about the, the, the physician and the provider experience. So from a safety and quality perspective, when you're identifying folks that that are let's call them frequent flyers, who are coming through the door constantly, we, that's not ideal. Because it may be heads in beds and maybe an old bottle in which you've just got people coming through the door and you're generating revenue as a hospital, but that's a zero sum game.
[00:08:19] And everyone loses with this fee for service. Boom, boom, boom has in beds. I would be really interested in how you identify those patients and then how can we serve them and reduce the likelihood readmissions, right. Cut down on their frequent flyer status. They would get less miles. That's fine. They don't need free tickets.
[00:08:36]And, um, the benefit to the, the, the providers and the organization also is that you're able to serve more people. More effectively, because then you don't have people coming through the hospital that are using up resources that we could apply elsewhere. And then we're able to think proactively about prevention, about, um, engagement for staff to be able to be part of these bigger solutions.
[00:08:58] So, and I could go on, I'll shut up, but, but really we're touching on safety, quality of the experience, the economics, um, and quite frankly, doing the right thing for the right reasons at the right time. And what you're touching on is the timeliness, because right now, as we speak, there's someone sitting in an emergency room who's suffering, who's constantly going through this revolving door and, um, it may be benefiting the, the, the, the system.
[00:09:19]Uh, that they're going through that door and there's, there can be an organization where they're not interested in, in helping stop that, but those organizations that are interested in stopping it, um, and cutting down on their frequent flyer status, uh, I can do better and save lives, save money, um, use better resources and, and do better.
[00:09:37] Good. I had my arm day glory to the greater glory. Yeah,
[00:09:39] Kellie Goodson, MS, CPXP: [00:09:39] Yeah. Yeah. And, and the way we do
[00:09:42] Patrick Swift PhD, MBA, FACHE: [00:09:42] this is probably more than you. That's
[00:09:43] Kellie Goodson, MS, CPXP: [00:09:43] No, no, that's
[00:09:44] Patrick Swift PhD, MBA, FACHE: [00:09:44] more than you plan on biting off, but you asked my opinion. So.
[00:09:47] Kellie Goodson, MS, CPXP: [00:09:47] Well, we do, you know, what we do is we, we can, uh, you know, find those patients by really dis-aggregating our data. So we look at data in the aggregate all the time and I'll stick with readmissions. So we know that heart failure, AMI pneumonia, CLPD readmissions, those are high rates. Of readmissions patients with those conditions, you know, automatically have these sort of higher rates of readmission than your average patient.
[00:10:13]So when we dis-aggregate that data, for example, we can find out, you know, these people from this certain zip code have higher rates of heart failure, readmissions, or, you know, we, when we desegregate the data, we actually can see what's happening.
[00:10:30]And I've got a really great example of a hospital
[00:10:33] Patrick Swift PhD, MBA, FACHE: [00:10:33] and then you identify a solution.
[00:10:34] Kellie Goodson, MS, CPXP: [00:10:34] Then you, then you identify Switzerland. So the, the hospital system Novant health they're based out of North Carolina, they, , dis-aggregated their pneumonia readmissions and found out that African-Americans in their hospital, had the highest rates.
[00:10:49] Of pneumonia readmissions. So they got a group together and went to work, use the traditional PI qui tools of improvement. And they did chart reviews. They did observations, they interviewed patients, they interviewed staff and they discovered some very specific things that they could do. That would help the African-American patients reduce those readmission rates.
[00:11:12]So, um, not only did they get rid of that disparity in the readmission rate between their African-American and all other patients, they re they dropped their pneumonia readmission for all of their patients. I
[00:11:26] Patrick Swift PhD, MBA, FACHE: [00:11:26] Yes. So I love that you said that because that's a win-win win.
[00:11:30] Kellie Goodson, MS, CPXP: [00:11:30] When, when, when am. And, um, I was really honored, uh, to nominate
[00:11:34] Patrick Swift PhD, MBA, FACHE: [00:11:34] Everyone benefits
[00:11:36] Kellie Goodson, MS, CPXP: [00:11:36] yes, and they, they won an award for it. I nominated them for the inaugural CMS office of minority health, health equity award back in 2018. And they were, uh, awarded that, that, you know, um, that distinctive award from CMS. So, not only is it a win for patients, it's a win for the organization.
[00:11:56] It's a win for everybody. Like you
[00:11:58] Patrick Swift PhD, MBA, FACHE: [00:11:58] I love it. I love it. So you're desegregating the data. You're plying that information. You're identifying solutions. And when you identify a solution, you're saying, and I, I want listeners to be aware that Kelly, what you're talking about is when you identify the problems and the solutions to it, then processes can be put in place that are helping everyone, not just a particular slice of the pie.
[00:12:20] That everyone benefits from this. So I want to challenge folks to be interested in what's going on in your organization. How is your organization looking at health equity? Because there are people, I mean, let's take the black lives matter conversation. I I've got friends . I love dearly and they get defensive saying, what do you mean black lives matter all lives matter.
[00:12:40] Well, of course they all matter. But when there are disparities related to black lives, well, injustice anywhere is injustice everywhere. Number one, but number two, there are people suffering as a result of systemic ways. We built health care. And so when we solve a piece of the pie, um, in one slice, the truth is that everyone wins.
[00:13:05] So when we're recognizing that black lives matter, um, everyone is winning. Um, if you want to drive a campaign for white lives matter, like what, what good is that doing? Uh, there's plenty of folks, white folks being a white, Hispanic myself, but being a white person, uh, the system is I'm certainly benefiting from being white.
[00:13:25]Um, but when it comes to addressing health equity, health disparities, um, black lives matter when we address the inequities inequities in healthcare, um, everyone's winning. So I'll get off that soap box, um, and go back to
[00:13:38] Kellie Goodson, MS, CPXP: [00:13:38] Well, the rising tide rises all boats. Right. And that, um, you know, and Patrick's
[00:13:44] Patrick Swift PhD, MBA, FACHE: [00:13:44] not voodoo economics.
[00:13:45] Kellie Goodson, MS, CPXP: [00:13:45] no, not
[00:13:46] Patrick Swift PhD, MBA, FACHE: [00:13:46] is, this is not a George Bush and we're not talking about voodoo economics here, but we are talking about, uh, all boats rising.
[00:13:53] Kellie Goodson, MS, CPXP: [00:13:53] Yeah. And you know, this is really what federal state, um, and even the CDC, um, has done with the COVID-19 data, right? So they dis-aggregated the data they've showed us the rates for the different populations that we have in our country. And we have Visiant did this as well. Um, and. You know, our, we have just wonderful, smart data scientists at Visiant, and they took all of our data.
[00:14:20] It's over 500 hospitals worth of data and they stratified our COVID-19 data by race. And ethnicity and it, you know, we found what you're hearing in the news, you know, that, uh, black and Brown Americans have higher rates of not only getting COVID, but being hospitalized for COVID and, and having COVID, you know, dying from COVID.
[00:14:45]So, you know, one thing that we did, so talk about, you know, sort of desegregation and investigation are really smart data scientists also added in age. So we have race, ethnicity, and age. And when you, you know, you hear about COVID-19 and you think, you know, those over 65 years old are most effected by it.
[00:15:04]Well, that's true if you're white, but if you're black or Brown, you are more effected by it. Between the years of 20 years old and 65 years old.
[00:15:14] Patrick Swift PhD, MBA, FACHE: [00:15:14] Mm.
[00:15:15]Kellie Goodson, MS, CPXP: [00:15:15] So when you really use the power of data to look and investigate and find you find things that you can actually do something about.
[00:15:25]Patrick Swift PhD, MBA, FACHE: [00:15:25] So what I feel you touching on under all this under these, you know, still waters run deep is we're talking about high quality care because when you're providing a high quality care, leveraging the data. To find evidence-based medicine. Well then when you're practicing evidence-based medicine, um, you're leveraging that data to address what the data's telling you, which happens to tell you this demographic, these, this attention, this demographic needs more of this attention to be mindful of that.
[00:15:58]Uh, and following what the evidence tells you, how to best, best provide care,
[00:16:02] Kellie Goodson, MS, CPXP: [00:16:02] Yeah, and I have another great example for you. Um, just along those lines, um, another, uh, visit member that I've worked with, um, Harbor view medical center out in Seattle, Washington. They've been working on this for decades and they are really sophisticated at this, but when they first started, you know, there, they went to stratify their data in.
[00:16:24]They didn't really have great patient demographic data. So that happens to a lot of organizations. They want to do this and they go try to do it. And it's, it's actually not as easy as it sounds. And then the data doesn't look right. And there has to be investigations around data collection and, and completeness and all that.
[00:16:41]But I tell them, don't let that stop. You. You can still do, you know, work in this area. And that's exactly what Harbor view did, you know, 10 years ago. And they were able to find out that, um, you know, for example, their colonoscopy screening rates for Vietnamese and Spanish speaking patients were way below.
[00:17:01]Those of English speaking patients. So what they were able to do by using the data and finding that out, they were able to provide prep clinics in Vietnamese. You know, they would conduct them in Vietnamese and in Spanish and their, , screening rates went way up and close that gap. So that's another example and that is in a hundred percent in control of a health system.
[00:17:25] You know, a lot of times health systems are asked to do like big things, like build a farmer's market or subsidize housing for patients. And it's so intimidating and they, they. They think about it. They get in that plan phase and they just kind of spin their wheels and they think, how are we going to do this?
[00:17:44] It seems so huge. And I always try and really just bring them back down into what they can control, which is the data that they already have. The patients they're already serving and the processes that they're using to take care of those patients.
[00:18:00] Patrick Swift PhD, MBA, FACHE: [00:18:00] Kelly. I love it. And I have to check. For those watching, um, I've laughed when you touched on the farmer's market. And the reason is that, um, there are organizations that will build the farmer's market just so they can look like they're trying to address community concerns and that's wrong. Uh, you know, th the notion here is that if you're going to build the farmer's market by God, you've got to be taking a look at what Kelly just spoke about, about the data, about how.
[00:18:23] Services are being provided and then being smart about how there is a strategy and plan in place to identify the problems and then identify the solutions, including making a farmer's market aisle. I want to shout out to Newark Beth Israel medical center in Newark, New Jersey, uh, near and dear to my heart.
[00:18:37]And they've done it, right? Yes. There is an amazing farmer's market, but it's more than just the farmer's market. It's about doing the right thing at the right time or the right reason and collectively having a good strategy in place, right?
[00:18:47] Kellie Goodson, MS, CPXP: [00:18:47] Right. Exactly.
[00:18:49] Patrick Swift PhD, MBA, FACHE: [00:18:49] Yeah. Yeah.
[00:18:50]Kellie Goodson, MS, CPXP: [00:18:50] You know, what I, what I want to say to Patrick is, um, you know, a lot of people think this is new. This is new information. Wow. These, you know, these patients are minority. Patients are not, uh, you know, having good outcomes here. This is not new. This is very, uh, long time coming for this to be put in such a spotlight now.
[00:19:09] And I, and I'm glad it is. Um, but back in the eighties and nineties, Even our own health and human services, , commissioned reports around looking at health disparities. And, , everybody knows about the IOM reports, uh, to err is human and crossing the quality chasm, and just shined a light on, um, how our quality in the United States is not up to par with other.
[00:19:35] Other countries. And so that was really the first time it was brought into the public that, Hey, maybe our us healthcare system isn't as good as we thought it was. and equity was brought up in those reports early on, and we've worked really hard as a healthcare system on the six aims that they set forth for us.
[00:19:53]and equity was one of those aims, but really, um, those of us had been working on this for a while. Call it the forgotten aim. So until COVID came around and we really started seeing these disparities in an active situation, you know, people didn't understand that these disparities exist.
[00:20:13]Patrick Swift PhD, MBA, FACHE: [00:20:13] and this applies not just to the us, but around the globe. Right?
[00:20:17]Kellie Goodson, MS, CPXP: [00:20:17] Yes. I mean, it, it, you know, it's, it's everywhere, unfortunately. in it's some of the systems that we have in place, you know, some of the, um, traditional, especially in America, Some of the things that the policies and even, you know, just access to good housing and education really affects, , our minority patients and, and it's it.
[00:20:39] And it manifests itself in these clinical outcomes.
[00:20:43]Patrick Swift PhD, MBA, FACHE: [00:20:43] you know, Kelly applying this on a global scale. , I'm curious about what's the most recent research on disparities that may be specific that your data may be, um, US-centric um, but it also parallels what we in your heart we know is happening on a larger scale. Right. , but can you touch on the more recent, uh, research.
[00:21:03] Kellie Goodson, MS, CPXP: [00:21:03] Yeah. Um, so the agency for healthcare research and quality puts out annual report, right? It's a, report. And I think that's been done for the last 15, 16 years. So if you look at that report, you will see that they, they studied 250 quality measures in that report. And fully 40% of those quality measures, which equals about a hundred quality measures that, , , black and indigenous people of color receive worse care than white people in that many measures.
[00:21:35] So 40%, which is a hundred measures. I mean, this, this is not, this is, you know, this has been going on for a long time and it's even things like the timely administration of medication for a heart attack. So black patients don't receive the right medicine in a timely manner when compared to white patients.
[00:21:54]We can all do something about this, right? We that's where, um, when you talked about that, this is about all of us. It really is.
[00:22:01] Patrick Swift PhD, MBA, FACHE: [00:22:01] And Kelly, I want to add, I'm familiar. I'm familiar with some of that research and that the research I've seen in the studies they've controlled for. Level of education, socioeconomic status, employment status. So even for example, addressing pain management for broken bones or pain management during labor and delivery, when you statistically control for a level of education, um, socioeconomic status, um, uh, employment status, when you pull all that out and just compare apples to apples.
[00:22:30], you're identifying, we're seeing in the data that there is a difference in care, and that's at the core of what we're talking about here. If we're not practicing evidence-based medicine, these kinds of disparities can exist.
[00:22:40] Kellie Goodson, MS, CPXP: [00:22:40] Exactly. And when up.
[00:22:42] Patrick Swift PhD, MBA, FACHE: [00:22:42] do the right thing happens.
[00:22:43] Kellie Goodson, MS, CPXP:: [00:22:43] And when we do the right thing happens, you know, when a patient is lying in a bed, you don't know if they're a CEO of a company, or if they're part of the janitorial staff, like you don't know who these people are in your bed, unless you take the time to get to know them. Um,
[00:22:57] Patrick Swift PhD, MBA, FACHE: [00:22:57] out to EVs. Shout
[00:22:58] Kellie Goodson, MS, CPXP: [00:22:58] yeah,
[00:22:58] Patrick Swift PhD, MBA, FACHE: [00:22:58] the janitorial staff narrative. They are the tip of the spear when it comes to infection control and addressing COVID. So a shout out to EVs. Go on, please.
[00:23:06]Kellie Goodson, MS, CPXP: [00:23:06] Um, so, you know, it's, it's just, this is, you know, of course, near, near and dear to my heart, my husband's an African-American man, and I want him to get the best health care that he can get. Um, my children are biracial. So, you know, this is really, um, you know, at the heart of what we're doing is treating humans as humans and giving everyone the best care possible,
[00:23:27] Patrick Swift PhD, MBA, FACHE: [00:23:27] absolutely. And the data we just touched on, you touched on, um, is government looking at disparities. So what about in the healthcare system perspective? What are they doing? What's the latest.
[00:23:39] Kellie Goodson, MS, CPXP: [00:23:39] You know, it's interesting because healthcare systems do have what they need to do, do this. Um, I gave you examples of Novant health and, uh, Harbor view medical center. Uh, and actually in, you mentioned at the top, I led a affinity group for CMS around health equity. Uh co-lead that with the New York state, um, health foundation and we, uh, got a big group of people together and we.
[00:24:04] Created what we call the health equity organizational assessment. So it looked at seven categories of data collection, data collection, training validation, data stratification. Uh, we looked at the cultural, uh, and organizational structures in place at hospitals to see how prepared they were to identify and address disparities.
[00:24:25]So, , we had over 2300 hospitals, , participate in this HEOA. Health equity, organizational assessment. And we found that, although they collect the data, they really don't validate it. Um, when they do stratify it, , they really don't know what to do with it and they don't really communicate about it. So it's, it's, there's, there's a real need here for hospitals to just start digging in and doing this.
[00:24:54] It, it, you know, it's something they're
[00:24:56] Patrick Swift PhD, MBA, FACHE: [00:24:56] Kelly, they're afraid. I've sat in the boardroom. I've sat in these conversations and it's a political conversation. It's a challenging conversation to collect the data. And then the fear that people have over recognizing, well, what if the data shows that we're not doing a good job and then how do we manage that?
[00:25:12] Number one, the feeling of powerlessness, what we, what to do. And, um, there are things that can be done right now and perhaps it may not be in-house and that's part of it is organizations. Considering getting help from outside counsel outside support to get some input on what to do with the data they've collected, the information they have.
[00:25:32] And I know for example, the kind of work that you do, Kelly, but, um, so how do I, how can they address in addition to the excellent kind of work you do? What are the barriers they can tackle to address these problems?
[00:25:43] Kellie Goodson, MS, CPXP: [00:25:43] Yeah. So, you know, what they need to do is they just need to get started. Stop spinning your wheels in that plan phase, take your data, do the analysis, and don't be afraid of it. I mean, if anything now is the time to do this. Right. It's
[00:25:56] Patrick Swift PhD, MBA, FACHE: [00:25:56] know I say that word a lot, but I'm needed. This is the time to do it.
[00:26:01] Kellie Goodson, MS, CPXP: [00:26:01] time to do it. Um, and look to others like, uh, um, I'm going to give another example. rush university in Chicago, um, they posted, um, their equity report. They called it a health equity report and they have this beautiful report that lays out all the disparities that they found. So just do an online
[00:26:21] Patrick Swift PhD, MBA, FACHE: [00:26:21] bold and brave.
[00:26:22] Kellie Goodson, MS, CPXP: [00:26:22] Very bold, very brave. It to me is the gold standard of what all hospitals and health systems should be looking at. It's it's amazing. I cannot say it enough. I would, if I had a magic wand, I would wave that around and have that be a requirement, just like a cha or maybe it's a, becomes a part of the, and a, the community health needs assessment that, uh, hospitals have to do every three years.
[00:26:47]It's it's amazing.
[00:26:49] Patrick Swift PhD, MBA, FACHE: [00:26:49] so you work at rush. Uh, you can be proud and celebrate that and hashtag it, celebrate it. Kudos. Great job. And if you don't take a look at your organization, And I don't care if you're in the C-suite your at the VP or director or a physician or working in finance or working in environmental services or working in nursing or working in physical therapy, it goes on and on and on.
[00:27:12]It doesn't matter where you are in the organization. Take a look at your organization. Is it doing something like that? And if they are please for God's sakes, say thank you to the leadership. And if they're not pay attention, And is there another organization and your town, that's doing the right thing that aligns more with these kinds of values that is doing the right thing for the right reason, the right time.
[00:27:37] Then maybe that's somewhere you want to be working because they really valuing not just the dollar, not just the, the, the, the business of healthcare, but they're honoring the, the practice of. Chair carry toss. Your they're honoring the practice of caring for human beings, caring for other human beings.
[00:27:56] And I know you would resonate with that kind of language. Right? Right. Kelly.
[00:27:59] Kellie Goodson, MS, CPXP: [00:27:59] Yeah, very much. So. I mean, this is just a, you know, uh, humans taking care of humans and, and, you know, it's, it's as much of an art. It is a science. And I just, you know, I just think now is the time, um, if you've been afraid to do this in the past, do it now engage patients and families invite them into your organization through P facts, and then, you know, take a look at your outcomes data, just pick one pick readmissions.
[00:28:27] I promise you, you will find something in readmissions, but you could look at, um, your, you know, Your care for diabetic patients, your care for our hypertensive patients, you will find some things that very specific things that you can fix. I promise you.
[00:28:41]Patrick Swift PhD, MBA, FACHE: [00:28:41] Love it love it. Kelly. My favorite question to ask my guests is if you were standing at the top of the world and you had the attention of all the healthcare folks, the docs and nurses and finance folks, and everyone who works in healthcare, and they looked up and you had their attention and you could say something, what would you say to them?
[00:29:00] Kellie Goodson, MS, CPXP: [00:29:00] No, I think first, I would say thank you, actually. Um, this has been such a trying time for everyone and, you know, healthcare. Professionals truly are our heroes. Um, it's so hard in, in when we say these things and we talk, we know this is not easy. Uh, we know this is difficult. So as Patrick said, you know, reach out, reach out for help. Um, you know, we're all gonna try to make this better for everyone, not only patients. And we want to reduce, uh, disparities, but we want our. Staff to find joy in their work and meaning and, and be happy. So, um, I think I would say thank you. And that we know this is not easy and, and we are.
[00:29:40]Patrick Swift PhD, MBA, FACHE: [00:29:40] Amen to that you are here to help and I'm grateful for all the work you've done with, with the work you've done with CMS and the P facts and the. Then on the national level and you've been inspiration at, uh, uh, international conferences. So what you shared here, , you've been sharing in conferences, uh, I've been touched by your leadership and, and really appreciate your thought leadership on a, on a global scale because you, you, uh, your principles and practices are, um, models for how to think about what we do.
[00:30:08]Um, but also how to feel, uh, connect to why we're doing what we do, and then be empowered to make that difference. Kelly. So thank you. If folks were interested in following up with you, um, how could they go about doing that?
[00:30:18]Kellie Goodson, MS, CPXP: [00:30:18] I think the best way probably is through LinkedIn. Um, I do have a page on LinkedIn and that's probably the best way to get in touch with me.
[00:30:26] Patrick Swift PhD, MBA, FACHE: [00:30:26] okay. Well, I will include that in the show notes and, um, gosh, Kelly, we've covered a lot of topics here, a lot of ground and learn so much. So I just want to say thank you for, for being a guest on the show. All you share the, the heart and passion for what you do and, and, uh, I'm grateful for your being a guest here.
[00:30:44]Kellie Goodson, MS, CPXP: [00:30:44] Thank you for having me, Patrick, it's been real fun.
 

Tuesday Mar 09, 2021

In this episode, we discuss courage and humility as essential for leading through a pandemic and beyond in order to save lives and honor your staff. Geoffrey Hall MBA, MSW has more than 20 years’ experience in Healthcare Administration and earned his MBA in Management and Operations from Walden University, a Master of Social Work from East Carolina University, and a Bachelor of Social Work from Auburn University. Geoffrey joined the Cleveland Clinic Rehabilitation Hospital system in October, 2016 and currently serves as the Chief Executive Officer for the Cleveland Clinic Rehabilitation Hospital, Edwin Shaw located in Akron, Ohio. Prior to this position, Geoffrey served as the Administrator for the nationally ranked Rusk Rehabilitation as part of the NYU Langone Health system from 2009 – 2016.
 
Geoffrey Hall MBA, MSW on LinkedIn
https://www.linkedin.com/in/geoffrey-hall-1988265a
 
Music Credit:
Jason Shaw from Audionautix.com
 
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to learn from audio interviews a way to participate.  Please enjoy!
 
[00:00:00] Patrick Swift PhD, MBA, FACHE: [00:00:00] Welcome folks to the Swift healthcare video podcast.
[00:00:03] Thank you for joining. I am delighted with our guests that I have for you. I believe this is a very special treat and a dear colleague and friend of mine I've known for, for 10 plus years. And I want to welcome to the show. Geoffrey Hall, Geoffrey. Welcome to the show.
[00:00:18] Geoffrey Hall, MBA, MSW: [00:00:18] Thank you very much.
[00:00:19] Patrick Swift PhD, MBA, FACHE: [00:00:19] Hey, I'm glad you're here. And folks, let me read you a bio for Jeffrey, and I think you're gonna enjoy this.
[00:00:25] Jeffrey Hall has more than 20 years of experience in healthcare administration. Jeffrey obtained an MBA in management and operations from Walden university. A master of social work from East Carolina university and a bachelor of social work from Auburn university to hear the thread of heart in the work that he does.
[00:00:42]He joined the Cleveland clinic rehabilitation hospital system in October, 2016, and currently serves as the chief executive officer for the Cleveland clinic rehabilitation hospital, Edwin Shaw, located in Akron, Ohio. Go Ohio prior to this position, Jeffrey served as the administrator for the nationally ranked Rusk rehabilitation as part of the NYU Langone health system from 2009 to 2016.
[00:01:07]And, uh, as a dear personal friend of mine, . I have traveled the world with Jeff. We haven't gone to China. We've gone to Qingdao and long Joe in Beijing and, and touch many lives. And. Moved education, health, education, medical education forward, and Jeffrey with all my heart.
[00:01:24] Welcome to Swift video podcast. Okay.
[00:01:26] Geoffrey Hall, MBA, MSW: [00:01:26] Thank you, Patrick. That was quite the introduction.
[00:01:29] Patrick Swift PhD, MBA, FACHE: [00:01:29] Well, there's a lot of love there. Right, right, right, right.
[00:01:32] Geoffrey Hall, MBA, MSW: [00:01:32] Absolutely.
[00:01:33]Patrick Swift PhD, MBA, FACHE: [00:01:33] So our episode for today, we are looking at leading through COVID and beyond if I had a sound effect, I would. Tied in, right. They're leading through COVID and beyond . Let's talk about this.
[00:01:46]Geoffrey Hall, MBA, MSW: [00:01:46] I would start by saying that, , certainly 2020 was probably one of the most interesting and maybe personally the most challenging years as a healthcare executive that I can remember and, I think you have to look back to how this pandemic started in end of February, early parts of March, and just the uncertainty and the, the prevailing sense of, of dread and even fear.
[00:02:10] , I remember just the one-on-one conversations with my frontline caregivers, nurses, therapists, doctors, , as well as our, our leadership team. And there's just so much uncertainty and so much unknown as, as COVID really started to kind of spread across the world. And I know here in our Cleveland, , Ohio area, , in the,
[00:02:32] partnership with Cleveland clinic. the entire region was just preparing for this massive surge of patients that looked like it was going to, at that time overwhelm the local hospital system, there was not going to be enough beds. There was not going to be enough caregivers. the Cleveland. Clinic itself was, , Decommissioned their state-of-the-art health education building, which is their newest building on their main campus and started to build a thousand bed field hospital.
[00:02:58] The convention center here in Akron was being turned into a field hospital and, , my location, , being primarily a rehab location was told, , that we were going to become a surge site and, , You know, that was a change in scope and change of focus and change of service line for us. And, , that decision was communicated to me just after five o'clock on one day.
[00:03:20]And I was told I needed to put together an emergency plan over 24 hour period. So, you know, leaving work after what is normally a long day, , went home and worked on this plan, , till at least midnight and, By midnight, we had, I had pulled together almost a 50 page plan of how I was going to change my building, into a COVID hospital.
[00:03:43]And, , communicating with my medical director, communicating with my leadership team. and then the next day, , 24 hours passes and I was told to kind of stand down. We're not going to do that. , We're we're, we're not, this is just a model. Let's, let's think this through. And then about three days later, , I got another call back from regional leadership and said, , not only do we need to stand this up, but how fast can you stand this up?
[00:04:07]And from that moment, I think the clock started and I had about seven days to alter my building through construction, creating new patient and staff entrances and entire new workflow processes. And how was I going to create a closed and segregated COVID unit that would not mix with my other caregivers and my other rehab patients.
[00:04:31], and then that plan had to be scalable depending on the size of the surge. It was a really dynamic time because when we were still as, as a community, learning about COVID and what were the risk factors? And this is before, you know, some of the lockdowns occurred. Some of the mask requirements occurred long before there was a vaccine on the horizon.
[00:04:53]so there was a lot of uncertainty and I was very proud of my team because we, we did stand up a COVID unit. , , in that short period of time, we built walls. We've changed workflow processes. , and we went from a place of uncertainty and.
[00:05:08] Patrick Swift PhD, MBA, FACHE: [00:05:08] for safety, right?
[00:05:09] Geoffrey Hall, MBA, MSW: [00:05:09] Yeah, we built physical walls, , for safety as, as a way to, , you know, really create distinct care areas.
[00:05:16], and of course, PPE and, you know, moving everybody into and 95 masks and all of the, the requirements that we've all heard about. So we did that in just over seven days. And then we started to admit, , COVID positive patients. , and we were one of the first rehab hospitals, , within our company.
[00:05:36]certainly our region that started to admit COVID patients and COVID recovery patients. And that really, , Changed our model and it kind of brought back this crystal focus on total care of the patient. And one of the unique things that we did, and I actually took away as a, as a best practice, if you will, is we aligned our nursing and therapy schedules to two identical 12 hour shifts and we made.
[00:06:03]Patient assignments as a team. And what was really unique in that is you had nurses, helping patients, , do their physical therapy exercises and get stronger. And you had speech therapist helping with bedside commodes and, you know, the toileting needs of patients. And it was less about your discipline and more focus on what does this patient need to get better and get stronger.
[00:06:28] And as a result, , the outcomes of this unit was so impressive. We had zero acute or emergent send-outs. We had zero patient falls. We had a hundred percent of our patients discharged home. , the gold standard for most rehab hospitals is about three hours of therapy per day, , which is pretty intensive.
[00:06:50] And in the early weeks of this unit, some of our patients, because. , they turned that corner with COVID and suddenly started to rapidly improve after these long hospitalizations, they were getting four or five hours of therapy a day because the team, again, around, around this total care, , was just really focused on creating great patient outcomes.
[00:07:10]And, you know, there were so many unique heartfelt moments around this because my staff went from a place of fear and. We don't know anything about this. We're, we're scared, you know, how are we going to be protected and how we're going to be safe? And that unit was formed with a hundred percent volunteers, nurses, therapists, housekeepers, , case managers, everybody that went on that unit volunteered for that duty.
[00:07:34] Um, and we're really at the tip of the yeah.
[00:07:37] Patrick Swift PhD, MBA, FACHE: [00:07:37] I'm sorry if I may ask, how did you do that? I mean, there's some, there's, there's so much you shared right there. The, the, the preparation that then led to patients and that led to saving lives by building what you built, and then you, you use the word volunteers, that you gave folks the opportunity to serve on these units.
[00:07:54]So. How did you do that?
[00:07:57] Geoffrey Hall, MBA, MSW: [00:07:57] Yeah.
[00:07:57] Patrick Swift PhD, MBA, FACHE: [00:07:57] saying folks who's, who's willing to volunteer? What was that like for you? W where there's so much media coverage, , and putting on pedestals healthcare providers is. Heroes. And there's actually been some backlash on that saying we're we're, we're, we're not wearing capes.
[00:08:12] We're, we're real people and we're suffering and struggling too. And we're self-sacrificing so it's not just a BS invitation. There is, there is the, the depth of that offer to serve. And self-sacrifice. So how did you as a CEO lead the team and lead folks to contemplate, to serve on a unit like that?
[00:08:29]Geoffrey Hall, MBA, MSW: [00:08:29] So there's a, I'll give you a little bit of a funny story to that. And then I'll, I'll give you a more serious answer. So as I'm doing this, , emergency preparation over the seven day period, our local newspaper in the Akron area ran a story. Uh, listing all of the hospitals that were preparing for this search, and this was not yet public information.
[00:08:51], so I'm walking into the building, I think six 30 in the morning. And one of my night shift nurse AIDS who's ending her 12 hour overnight shift is walking out into the parking lot and stops me and says, Oh, I saw in the paper that, , our hospital is becoming a COVID hospital. And that is not how I wanted that information to roll out
[00:09:14] Patrick Swift PhD, MBA, FACHE: [00:09:14] how you want your photo roll out,
[00:09:17] Geoffrey Hall, MBA, MSW: [00:09:17] no, and, um,
[00:09:18] Patrick Swift PhD, MBA, FACHE: [00:09:18] although it's great. You've got to engage an employee. Number one, the employees reading the headlines and, and she sees the CEO. And instead of not talking, she walks up to you and shares with you. The so kudos on that , you know, we can control everything right.
[00:09:32]Geoffrey Hall, MBA, MSW: [00:09:32] It rolls out. So I walked into the building, I'm shaking my head and then call the, an emergency management team meeting, um, assembled , our medical director and medical staff. And then, , over the course of the next two hours, I walked them through this, this plan that I had put together in 24 hours.
[00:09:51] But more importantly than that, , When you're dealing with something that is moving as fast as COVID and creating as much change as COVID, , I'm going to give the simple answer of you have to go beyond an email. Like you can't just send out a memo. You can't just send out an email when you're talking about people with questions and fear, and then they start personalizing this to their family, and then the reasons why they would or would not volunteer for a unit assignment like this, You can't overstate the importance of that one-to-one conversation.
[00:10:21] And what we did was really powerful as my, medical staff combined with my nonclinical areas. So housekeeping, dietary office staff, , they didn't have their clinical knowledge to draw on. So we did in-services and every single day we do what we call what's. walking rounds where we're engaging our caregivers, we're asking them questions, but most importantly, we're taking that as a chance to listen, what are your concerns?
[00:10:49]And then after we listen, that's when we give support. And then after we give support, that's when we give education. So it's kind of the old saying of no one cares how much, you know, until they know how much you care. So I think these walking rounds where the formula for that, I think they. Reinforced to our caregivers who were being asked to do very difficult things, things that they had never done in healthcare before.
[00:11:13]first we're, we're going to listen to you so you can, you know, Push back on us and then we're gonna support you. And we're gonna reinforce that we really care about your safety and our patient's safety, and that we have the expertise to do this, and then we're gonna educate you about the right way to wear PPE and the buddy system to make sure we're wearing it appropriately.
[00:11:32]You know, the, those,
[00:11:34] Patrick Swift PhD, MBA, FACHE: [00:11:34] Tell us more about that
[00:11:36] Geoffrey Hall, MBA, MSW: [00:11:36] yeah. So, you know, . It is pure accountability that, , they're watching your back. You're watching their back because when you're having to put on and 95 mask, eye protection, gowns gloves, and you're caring for a highly infectious patient. the PPE is proven through science that it's going to keep you safe.
[00:11:55] We've been using it in healthcare for over a hundred years. That's why we wear gloves. That's why we wash our hands. But. When you're having to do this for every single patient that you're caring for having somebody to make sure that you've, you've tied your gown and it's snug, and that you've, , you're removing your gloves the right way.
[00:12:14] So using the buddy system and empowering our staff to be responsible for safety, , and connecting it back to, you know, that purpose. And I think. We're lucky in healthcare that most people come into healthcare because they want to help others. , but now you have to take it to a different level and COVID it really just reinforced because it was changing so fast in those early months, we would set out a protocol in the morning and by four o'clock in the afternoon, it had changed.
[00:12:45] And the confluence of, of so many different voices, both at a. National and federal level and then a local and regional level. it was things were changing so fast. I've never seen anything in my 20 years of healthcare where, you know, information had to be validated, implemented, and. Rapid cycle kickstart and to action, so quickly and every single day it was doing this.
[00:13:14] So we, we ended up starting, , where we have normal morning meetings. We were having huddles at first, started the day, mid day, end of day. And we were doing these check-in calls. Just so we could rapidly get the information out. but then you had to follow it up with those walking rounds and those one-to-one conversations.
[00:13:34] So, , you'll hear this a lot in my responses, but it's, it's focusing not only on the task, but it's really focusing on the people behind the task. , you know, I think, I think as leaders, we sometimes need to be reminded that we manage things. We lead people.
[00:13:51]Patrick Swift PhD, MBA, FACHE: [00:13:51] I was going to ask you, how did you change your leadership style in multiple directions? Both from regional pressure. Or direction you receive from your senior leadership as well as how you supported others. And that, that dovetails right into that, that topic of how you shifted your style. And I love your point it's it's worth you saying that again.
[00:14:13] I love that
[00:14:14] Geoffrey Hall, MBA, MSW: [00:14:14] Yeah. No. So I think as leaders, we need to be reminded that we manage things, but we lead people. And, you know, as we went through this, , my, I watched my own leadership style change quite a bit because, , I had to one, , consider my audience, , , of how I was writing and communicating and my verbal communications.
[00:14:38] And then going back to check, did you receive what I intended to say versus what you perceived? I said, and having the trust and the accountability and making myself really vulnerable.
[00:14:50] Patrick Swift PhD, MBA, FACHE: [00:14:50] Ooh, I want to talk about vulnerable pleasing. Let's let's include that in highlighter, vulnerability as leaders, how you manage that.
[00:14:57]Geoffrey Hall, MBA, MSW: [00:14:57] , I think, um, I think being an effective leader and today's world, you have to be able to be in touch with your emotions.
[00:15:08] And I'm going to actually say that you should be comfortable using your emotions, not losing your emotions. So no one wants to have the leader or boss that loses their temper and just like flies off the handle. And I say that and I mean that, but at the same time, , our patient's safety really matters.
[00:15:26] And if you got one person that's refusing to wear a mask or, , not washing their hands or not taking some of these precautions safely, it's okay to be disappointed. And to really connect it back to not just, this is a task that I'm expecting you to do, but here's the why behind it. And, , I think it's okay to be passionate about being the best and having the highest quality.
[00:15:54] I think it's okay to, want your patients to get better, not worse while they're in your care. I think it's. Okay to say I'm scared and I'm tired and I'm exhausted because when COVID started, I worked three months in a row without a day off. , and to say I'm really, you know, exhausted. and I'm, I'm, I want to step back, but for me to step back, I need you to step up.
[00:16:16]And I had some of those conversations with my leadership team, because we were. , convening these leadership huddles seven days a week to make sure we were on top of this. And you have to also pay attention . So when they start to get tired and they start to, you know, feel and express themes around being burned out and being exhausted or being scared, you need to give people permission.
[00:16:41] To cycle down and or say, I really need help. I'm exhausted. I'm going to take Saturday off. If you can help me cover this activity. , it all goes back to communication and how we support each other. and that's one of the things that I was really proud of personally, but also I just saw countless examples of how do we care for each other and.
[00:17:04] , using that emotion and passion and to create that connectivity. and just really having honest conversations, which means not just telling everybody you're doing a great job and that's important to say, but it's having the courage to say. We need to improve in this area and it's not personal.
[00:17:24] It's not, you need to improve. We need to improve. and we're in this together and here's what we really need to focus on right now. If we're gonna create these great outcomes and get our patients home, more importantly, how are we going to keep our staff safe and how are they going to be able to keep their families safe?
[00:17:42] So, , I, I don't know that there's a start and end to that, but this past year, There's so much more reflection on vulnerability and being authentic with people and using that authenticity to give real support, not just kind of, uh, , easy conversations. and the challenge with that, and it's really impacted our leadership style is COVID has kind of taken away all of those.
[00:18:08] Social norms of eating together and celebrating together and , how do we come together? Like even now our hospital meetings are all virtual zoom based. So even the ability to be in the same room and have conversations. So we've had to kind of shift to a more virtual world and more socially distance world
[00:18:30] yeah.
[00:18:30] Patrick Swift PhD, MBA, FACHE: [00:18:30] you all on that, uh, how you're, how you're driving cultural engagement, , and those quality conversations in light of what you just said, that there is such disconnection at the same time as to need for us to be connected.
[00:18:41]Geoffrey Hall, MBA, MSW: [00:18:41] no, I don't know that I have, , the complete formula figured out, but I think just as you would do in a regular meeting where you all come into a larger space or a conference room, when you're on a zoom call with. 10 plus people, you still have to make time for that. Pre-meeting post-meeting smalltalk, like really checking in with people.
[00:19:02]And that's something that I've started to do is I run meetings via zoom quite regularly. Now is at the beginning and end of the meeting, I'm going to ask a more thought provoking, more personalized question. And I'm going to give people some time to kind of respond. And then we interact with each other off of that, because you can get so focused on this is what we're talking about in this meeting, that those small interactions that validate us as human beings and connectivity and purpose.
[00:19:31] We miss that though, those water cooler conversations, those coffee pot conversations, the everybody kind of. Sidebar chatting before the meeting starts
[00:19:41]Patrick Swift PhD, MBA, FACHE: [00:19:41] I want to. Jump in on that one, because you remind me of one of our heroes and someone you and I both Revere, which is Steve Flannigan, Dr. Steve Flannigan, Steven Flannigan. And in a, in a meeting this was years ago. I mean, I had hair and, um, we were at NYU. We were in a big room with a lot of folks and Dr.
[00:20:01] Flannigan was speaking to the audience, the group, and he. At the end of the end of the staffing, he asked what questions do people had any explicitly sad. I'm going to count to myself to give you time. So think about what you want to ask, any, any, any was jokingly, but like one, two, it wasn't like, yeah, there we go.
[00:20:25] He count to eight. Like he'd let people know, not from like, we get to eight and I'm out of here, but I really want to give you time to answer. Or, and you just touched on zoom calls where you're asking a thoughtful question and that's demonstrating the heart of leadership. That is the, the lion heart of leadership where you're not afraid of what.
[00:20:45] Someone's going to say there's co-writes there's courage there. There's heart. So I appreciate your bringing up pausing and thanks for reminding me about Dr. Flanagan and his example to us
[00:20:54]Geoffrey Hall, MBA, MSW: [00:20:54] Now I learned so much from, from Dr. Flanagan. And I remember those pauses at the end of meetings, because whether people had something on their mind that they were ready to talk about or , they just needed that space. Um, And people want to fill that space. So you've got to build in and
[00:21:14] Patrick Swift PhD, MBA, FACHE: [00:21:14] space, right?
[00:21:15] Geoffrey Hall, MBA, MSW: [00:21:15] you've got to build in some time with your virtual meetings to let people be people.
[00:21:19] And I reminded of that every single day. The other thing I love about Dr. Flanagan's and she brought him up and I think it's a good reflection as a leader. Is finding ways to say yes and he just embodied that so much. And I try to bring that into my own style because it's easy for us to just say no of why something can't happen, but you start to open up all these possibilities when you start to think or give yourself permission to think or others to think what if we said yes.
[00:21:49] And I think that really created a lot of success, even with this COVID unit, , not finding wise. We can't because we're a rehab hospital and we don't do COVID, but instead
[00:22:00] Patrick Swift PhD, MBA, FACHE: [00:22:00] do things around here. Right? The perspective, how can I say yes.
[00:22:04] Geoffrey Hall, MBA, MSW: [00:22:04] yes. And then if we're going to say yes, how do we do it well
[00:22:08] Patrick Swift PhD, MBA, FACHE: [00:22:08] Hmm, right?
[00:22:09] Geoffrey Hall, MBA, MSW: [00:22:09] or better?
[00:22:10] Patrick Swift PhD, MBA, FACHE: [00:22:10] at the right time, at the right reason with the right goal and, and discerning that. Beautiful.
[00:22:16] Geoffrey Hall, MBA, MSW: [00:22:16] It's, it's completely empowering.
[00:22:18]Patrick Swift PhD, MBA, FACHE: [00:22:18] Hey, let's talk about one of the one concept you and I have touched on is responsibility to and responsibility for you. Threw that out there on another conversation we were having.
[00:22:29] And I want to ask you to, to, , unpack more of that because I like the direction that's hinting. It's going,
[00:22:35] Geoffrey Hall, MBA, MSW: [00:22:35] Yeah, so I use the, the. Difference between responsibility too and responsibility for, , as I'm training new leadership and new managers, because we sometimes think that. Mistakenly think that we're responsible for the actions and behaviors of other people when intellectually, we all individually know that that person is responsible.
[00:22:59]But when we, we have managers and leadership, we feel a certain amount of ownership and you own your quality. You, you own your team, you own the identity and reputation of, of your organization. And you feel like that's a reflection and. You know, I think we have to make that distinction. And if you're responsible to someone you're giving them feedback, you're being honest.
[00:23:25] You're giving them, , Opportunities and time to correct, and to learn from, , you're giving the training, you're giving the education and then it's up to that person to do something with that. And whereas if I'm responsible for something, then you, you. Sometimes go down the slippery slope of thinking that you're the only person that can do that.
[00:23:50] Or you're the only person that can make a decision or you're the only person that can create a successful outcome. And when you start to pull it back and feel like I have to do it myself, My honest opinion is I think we're starting to fail as leaders and that doesn't mean leaders. Aren't high-performing overachieving, get things done, kind of people, , but if you're going to trust and empower and build and be a people builder, then you have to be able to identify and have that hard talk with yourself sometimes.
[00:24:21] Am I being responsible to this person and giving them all the feedback and education training support to be successful. Where am I feeling responsible for this person? And there were times in this past year, thinking about the urgency of COVID in our hospital operations, I've felt a lot of responsibility for, and I.
[00:24:42]To not disempower or lose or disengage or burn out my team. I had to be able to pull myself back and say, I'm going to be responsible to this person. And I'm going to trust and empower this person to be an extension of my vision, of what I want to accomplish. And we accomplished a lot more together than I could have done by myself.
[00:25:01] So I just think it's, it's a really. Great topic. And I don't know that you ever completely resolved that balance cause it's a Seesaw. , where, , you do have to have some ownership and you do have to have some passion and you have to have high levels of engagement and follow through. But at the same time, if you're doing this with people in leadership, it's separating the responsible to versus the responsible for
[00:25:27]Patrick Swift PhD, MBA, FACHE: [00:25:27] I like to call that the yoga of healthcare, where we're we're as leaders, we're staying flexible at the same time to support, um, the good work that's being done. It's a beautiful way to, to, to, um, Put that together. Jeffrey also want to talk with you about the patient experience and challenges and lessons learned during the past COVID adventure and, , , your future vision of how you're advancing the patient experience.
[00:25:55] Geoffrey Hall, MBA, MSW: [00:25:55] That's a, that's a great question. I think it's evolving. , so in our hospital setting, we do a significant amount of family training where we involve, , Adult children, spouses, family members in the care of the patient, because our goal is to get those patients home. And you're moving from a setting where you have 24 hour nursing care and great therapy care to your home environment, which really doesn't have as much of the same supports and infrastructure. , as part of COVID, as we had to lock down and change our visitation processes, we really had to implement some new ways to continuously get our patients home, despite not having people onsite. And on-premise so. We implemented a lot of virtual FaceTime training, , where therapists and nurses working with a patient would have, , the family member on a video screen and interacting in the session.
[00:26:49], we converted all of our support groups, , for brain injured patients and spinal cord, injured patients and stroke patients to virtual. And , what the unintended benefit of that was is that. , we sometimes think that we start a group and it's just accessible to everyone, but not everyone has transportation or the availability to come to a, , a group setting or a hospital setting.
[00:27:14]So our participation and enrollment in some of these groups, nearly tripled because the virtual aspect gave more access to care and access to follow up. And. What was really powerful, particularly with our COVID support group was the peer support. It wasn't the healthcare professional, leading the discussion.
[00:27:35]It was everyone else talking about the long haul symptoms that they had, how that had impacted their family. Um, and Mo more importantly, , I think there was such a stigma around the, the patients who were early diagnosed with, with COVID. And it started to kind of normalize that. So we really went to a virtual strategy and certainly across healthcare, you're seeing an explosion of, tele-health, which has been around for years, but it's now becoming mainstream because it's creating a better access of care.
[00:28:09] If you think personally, why would you want to go to a crowded doctor's waiting room or an emergency room right now, if you could access the same doctor and actually have. A really personal conversation with that doctor about what's going on with you via your phone versus doing that. And I'm not saying healthcare should be all virtual because there from a patient experience, , one of the, because we had to do when we, we limited our visitors and had no visitors during the hall days, is we just task staff every day to say, You need to go do some social rounding.
[00:28:43] Like I want to, like, there's no task, there's no activity, there's no procedure. I just need you to go in and have a conversation with how this person is doing and keeping that human connection. you know, we brought in musicians and it was one of the best things I saw in 2020, where I had a opera singer and a violinist in a hallway.
[00:29:05] And because we had to be socially distance. Our patients came to their doorways of their patient rooms and sat in the doorways so that they were more than six feet apart. And in the center of the hall, I've got somebody playing a violin and an opera singer and lots of hospitals do those kinds of things on a regular basis, but doing it in a COVID
[00:29:24] Patrick Swift PhD, MBA, FACHE: [00:29:24] during COVID that's that's, that's unusual and it speaks to patient family centered care. And I love what you said earlier about it. Not just being a top-down , the clinician. Doing training to the family. But you said that the family are speaking up and part of the conversation during those, the peer to peer support, that's patient, family centered care where they, they, they have the voice, it's the collective it's us together, as opposed to a sense of separateness.
[00:29:54] Geoffrey Hall, MBA, MSW: [00:29:54] And I would say in healthcare settings, we often focus on our patients and you'll hear patient centered care. And that's been a buzzword for the industry for years, but I want to expand that because we had to go through this. And this was a hard learned lesson for us. Is when we first went through our COVID rollout and our changed our operations, we were really well focused on the staff experience and the staff education and the staff safety.
[00:30:21]And I actually had a patient in our hospital who was, , recovering from a spinal cord injury and was hospitalized before the COVID lockdown and then was with our hospital as we made all of these. Drastic changes with COVID precautions. And he came to me and he said, your staff are great. You know, they really know what they're doing.
[00:30:40], I really see that they, they feel like you've got this COVID thing under, under control, but my family is concerned. And so what can you do around that? So I sat with him for a couple of hours and he. Rattled off a number of questions. And then as a leadership team, we went back and we had to revisit every single one of those questions with the lens of how do we communicate this to not only this one patient, but patients going forward. So as a result of that, we came up with a new family communication plan and who is making the calls.
[00:31:13] And how often are we making the calls? And what's the content of this call and how are we. Passing this off and how are we just acknowledging that families are anxious because they can't see their loved ones right now. And all of this other stuff is happening in the world. , so let's kind of raise the bar on customer service and you know, some of that was FaceTime calls and, and our rec therapists did an amazing job of using FaceTime to do virtual visits.
[00:31:42], We did a virtual 70th wedding anniversary for one of our, our patients and their families. , cause the spouse was hospitalized. You know, we had to rethink of how do we help families celebrate birthdays and anniversaries. And I really want to stress that family communication. Cause it's real easy to go rounding and go talk to a patient and explain to the patient.
[00:32:04] But you've got to do that two or three times. If they've got a son and daughter that live out of state, a family member that lives in the local area, like sometimes you would learn that you're having all these update conversations with a family member, but they're not the decision-maker family members.
[00:32:21] So really trying to and not be defensive about that and say, Okay. You're not here. So we can't share this information in person. So what extra level can we go to, to make sure that your experience matches the same care that we're providing to the patient?
[00:32:38] Patrick Swift PhD, MBA, FACHE: [00:32:38] Outstanding. Standing
[00:32:39]One of the questions I love to ask, and I want to ask you, if you were standing at the top of the world and you had the attention of all the healthcare folks, physicians, nurses, therapists, staff, leadership, all the folks who work in healthcare for a brief moment what would you say to, to healthcare across the planet right now?
[00:33:01] Geoffrey Hall, MBA, MSW: [00:33:01] Well, I'll answer that with what I wish somebody had told me, and I've had to figure out and continuously remind myself of, and it's to focus on the people, providing the care. And it's my belief that if our caregivers feel supported and, , we're really developing them from a skill enhancement, but just focusing on empathy and their overall experience.
[00:33:26] Then it's not unreasonable to expect great patient experience and great outcomes, but we have to focus on the caregivers. I think oftentimes we bury people with tasks and audits and activities, and we need to remember that there's a person that's behind that. And, , I think I want us to become more, , accountable for.
[00:33:51] Development and resilience versus a burnout culture. , because that was one of the key things that I was reminded of this year was we had our third wave of COVID surge across our community. , and I started to see at one point our local area was that a 33% positivity rate and. There was no backups.
[00:34:14] There was no additional nurses or nurse AIDS or therapist on the bench that could come in and take care of our patients. , so it was mission critical that we tried to keep our own staff safe. and just managing that because even one person calling out was the difference between a good shift and a bad shift, a good day and a bad day.
[00:34:37] So. For me, I wish somebody had even earlier had reminded me to just focus on the caregivers. And if you do that, the caregivers will remember and take, take great care of the patients.
[00:34:50] Patrick Swift PhD, MBA, FACHE: [00:34:50] you're here , and that is global thought leadership in healthcare. Right there to a T when I ask you if folks who are interested in following up with you or had a question, uh, , how could they, uh, get in touch with you?
[00:35:02] Geoffrey Hall, MBA, MSW: [00:35:02] Sure, absolutely. And thanks for the time Patrick. I always enjoy our conversations. the best way to reach me would be, , my email address. And, um, would you like personally?
[00:35:11]Patrick Swift PhD, MBA, FACHE: [00:35:11] uh, well, I'm not gonna put that on the show, but how about, how about your LinkedIn profile? If, if folks are interested in connecting with you on LinkedIn,
[00:35:18] Geoffrey Hall, MBA, MSW: [00:35:18] yeah, I'm not on other social media channels, but you can certainly find me on LinkedIn.  , , , but I am the kind of CEO that gives my personal cell phone number out to my patients, their families, my staff. , cause I don't know if you can care about people and just have a start and stop time.
[00:35:34]Patrick Swift PhD, MBA, FACHE: [00:35:34] beautifully said beautiful leadership, beautiful perspective. . Jeffrey, thank you so much for, for being on the show. Thank you for being on the Swift video podcast with healthcare video podcast and, uh, folks, , , I hope that you, , take away nuggets from what Jeffrey had to share and, , , Jeffrey, thank you so much for being on the show.
[00:35:51]Geoffrey Hall, MBA, MSW: [00:35:51] thank you, Patrick.
[00:35:52]
 

Friday Mar 05, 2021

Dennis Volpe is a former EMT who brings over twenty years of experience as a career Naval Officer. He is an International Coaching Federation (ICF) Professional Certified Coach (PCC) with the Leadership Research Institute specializing in Performance, Personal Leadership and Transition Coaching. In this episode, we discuss how to develop your emotional intelligence through self-awareness and feedback, the benefit and pitfall of EQ, and practical advice how to keep your own needs top of mind while caring for others.
 
Links for Dennis Volpe:
https://transitiononpurpose.com/
https://www.linkedin.com/in/djvolpe/
 
Music Credit:
Jason Shaw from Audionautix.com
 
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

Wednesday Feb 24, 2021

In this episode, Aysha Gardner speaks about her article published by the Markkula Center for Applied Ethics at Santa Clara University addressing health equity for vulnerable populations, exposing the practice of gynecological surgeries being forced on women in ICE camps in Ocilla, Georgia that was widely reported in the NY Times. Recognizing that this is a much bigger issue in healthcare than just one instance, she shares what healthcare providers and leaders can do from her perspective to help stand up against these and other unethical practices. Ms. Gardner is a health care ethics intern at the Markkula Center for Applied Ethics at Santa Clara University, the Jesuit university in Silicon Valley.
Aysha Gardner on LinkedIn
https://www.linkedin.com/in/aysha-gardner-43b386b4/
Further Reading
https://theintercept.com/2020/09/14/ice-detention-center-nurse-whistleblower/
https://www.nytimes.com/2020/09/16/us/ICE-hysterectomies-whistleblower-georgia.html
https://www.nytimes.com/2020/09/29/us/ice-hysterectomies-surgeries-georgia.html
https://projectsouth.org/wp-content/uploads/2020/09/OIG-ICDC-Complaint-1.pdf
https://projectsouth.org/
Music Credit:
Jason Shaw from www.Audionautix.com
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

Tuesday Feb 23, 2021

Dike Drummond MD, a Mayo trained Family Practice physician, burnout survivor, executive coach and founder of TheHappyMD.com joins the Swift Healthcare Video Podcast to discuss physician leadership, building trust as a leader, and the difference-maker in meaningful communication.
 
Links for Dike Drummond MD:
https://www.thehappymd.com/
https://www.linkedin.com/in/dikedrummond/
https://www.youtube.com/user/thehappymd
@dikedrummond
@thehappymd
 
Music Credit:
Jason Shaw from Audionautix.com
 
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

Tuesday Feb 23, 2021

Through a compelling blend of personal experiences and scientific evidence, Patient Lee Tomlinson demonstrates how the simple concept of compassion can improve patient outcomes, reduce healthcare professional burnout, and drive organizational success. In this episode, we discuss the naked truth about compassion - and what healthcare professionals can do to experience more compassion in their own lives.
 
Links for Patient Lee:
https://www.leetomlinson.com/
https://www.linkedin.com/in/leetomlinson/
 
Music Credit:
Jason Shaw from Audionautix.com
 
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

Tuesday Feb 23, 2021

Dennis Volpe is a former EMT who brings over twenty years of experience as a career Naval Officer. He is an International Coaching Federation (ICF) Professional Certified Coach (PCC) with the Leadership Research Institute specializing in Performance, Personal Leadership and Transition Coaching. In this episode, we discuss the Stockdale Paradox, how to balance optimism and realism in light of the war on COVID, and best practices how to restore your resilience in the face of adversity.
 
Links for Dennis Volpe:
https://transitiononpurpose.com/
https://www.linkedin.com/in/djvolpe/
 
Music Credit:
Jason Shaw from Audionautix.com
 
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

Tuesday Feb 23, 2021

Grace Marin RN, MSN, MBA, CPXP is a NICU nurse who has held progressive leadership roles and believes that the Patient Experience cannot improve unless those closest to the bedside feel valued, acknowledged, and appreciated for the work they do every day. Grace is a nurse and coach who cares deeply about the humans who care for other humans. In this episode, we discuss some of the key elements in crucial conversations and what it takes to be an effective healthcare provider, leader, and communicator.
 
Links for Grace Marin RN, MSN, MBA, CPXP:
https://gracemarin.podia.com/free-5-day-e-mail-course 
https://www.linkedin.com/in/grace-marin-msn-mba-rn-cpxp-6698962b/
 
Music Credit:
Jason Shaw from Audionautix.com
 
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

Tuesday Feb 23, 2021

Dike Drummond MD, a Mayo trained Family Practice physician, burnout survivor, executive coach and founder of TheHappyMD.com joins the Swift Healthcare Video Podcast to discuss physician burnout, how to recognize and prevent it for both individual doctors and healthcare delivery organizations with healthcare professionals from all disciplines.
 
Links for Dike Drummond MD:
https://www.thehappymd.com/
https://www.linkedin.com/in/dikedrummond/
https://www.youtube.com/user/thehappymd
@dikedrummond
@thehappymd
 
Music Credit:
Jason Shaw from Audionautix.com
 
Transcript:
A transcript for the show can be found via the closed captions for each episode on our YouTube channel at https://www.youtube.com/channel/UCZ6_S4bBlaMyyC00kKGAsFg.

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Swift Healthcare Podcast

Welcome to the Swift Healthcare video podcast! This Podcast is for you – healthcare folks. It’s about your needs, as providers, as leaders, clinicians, team members, professionals. Each episode, Dr. Swift will have a conversation with a thought leader touching on Healthcare and Leadership, including perspectives from within and from outside healthcare.

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