Needle-moving innovations from 86 health system execs

Needle-moving innovations from 86 health system execs  unknown

Becker's asked C-suite executives from hospitals and health systems across the U.S. to share their organization's areas of growth for the next few years. 

The 86 executives featured in this article are all speaking at the Becker's Healthcare 14th Annual Meeting on April 8-11, 2024, at the Hyatt Regency in Chicago.

To learn more about this event, click here.

If you would like to join as a reviewer, contact agendateam@beckershealthcare.com. We'll fully cover your registration fee! 

For more information on sponsorship opportunities, contact Jessica Cole at jcole@beckershealthcare.com.

As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.

Question: What is the most needle-moving innovation you've rolled out in the past year and why?

Michael Slubowski. President and CEO of Trinity Health (Livonia, Mich.): We're moving the needle with our innovative care model, TogetherTeam Virtual Connected Care™. This nurse-led model uses a three-person team, partnered with technology to enhance patient care and support direct care staff. Patients receive comprehensive care from a collaborative team, made up of a direct care registered nurse, a nursing assistant or LPN, and an on-site registered nurse connecting virtually. This is truly a transformation in care delivery. We continue to see encouraging results in nurse and care team engagement, reduced turnover, improved quality and safety, and patient and family satisfaction with their care. As of this month, we are live at 21 hospitals in 10 states, covering almost 1,900 beds in 57 nursing units. 

David Lubarsky, MD. CEO and Vice Chancellor of Human Health Sciences at UC Davis Health (Sacramento, Calif.): Last October, all six University of California Health locations joined forces to launch ValidAI - an open innovation collective for healthcare organizations of all sizes to learn from each other the science of validating, executing, and creating value from generative AI. In a few months, it has become the largest member-led collective in the U.S. focused on Generative AI with 50+ members. 

Generative AI is creating a problem of plenty, as now any high school student can build an algorithm, and healthcare organizations need to find what can provide the most value. This is even more pressing in today's environment where many health systems cannot just hire AI engineers like Google/Microsoft, or well-funded start-ups. Few organizations have the time, skill or resources to ride the coming tsunami wave of Generative AI, but working together we can learn how to use it to create value for our patients, clinicians, scientists and employees.

Craig Kent, MD. CEO of UVA Health; Executive Vice President of Health Affairs at University of Virginia (Charlottesville): As one of our strategic initiatives to elevate UVA Health as the best place to work, we introduced the UVA Health Leadership Institute in late 2023, resulting in overwhelming interest from our employees. Hundreds of impressive candidates applied to participate in the first cohort of 30 individuals, and we responded by immediately fast-tracking the creation of a second cohort. 

The Institute's mission is to improve culture and make UVA Health a best place to work by nurturing leaders from within the organization — a key contributor to our system's long-term success. The cohorts meet monthly in sessions built around three modules – leading self, leading teams, and leading systems – and culminates in capstone projects that tackle critical challenges and priorities for UVA Health. The Health Leadership Institute will have a long-lasting positive impact by producing more leaders in the organization. We will benefit from a sustained culture of continuous improvement by creating a pipeline of exceptionally well-trained leaders.

Neil M. Meltzer. President and CEO of LifeBridge Health (Baltimore): LifeBridge Health is building a legacy of reimagining what a community health system can be. Our Center for Hope is a national leader in comprehensive and integrated programs to advance hope, healing and resilience for those impacted by trauma, abuse and violence. Some may question why a health system is involved in community violence intervention, gun violence prevention, child abuse, etc. With cancer or heart attack, we understand the benefits of preventing these illnesses rather than having to treat them. The same can be said in taking a public health approach to violence; we aim to save physical, emotional and ongoing trauma to individuals and communities. Over the last year, we have seen how this integrated approach to violence (along with many partners in our communities) has helped to move the needle and lower the number of gunshot wounds and traumas we are seeing across our city.

David Goldberg. President, CEO, and Executive Vice President of Mon Health System, Vandalia Health (Charleston, W.Va.): In 2023, our revenue cycle team, led by Christine Sturtevant, has implemented RCAT (revenue cycle action teams) to identify front line-identified issues to broader colleague-identified opportunities to ensure we have systems, processes and properly educated clinicians/team members in place to support our clinically led revenue cycle for proper, timely payment of services rendered. 

This has been game changing for our team members. This process empowered all areas of our organization and improved cash flow, revenue realization and sustainability. Our cash collections are on a record pace and our revenue cycle teams are engaged, seeing improvements they lead make the difference and we are harnessing the improved cash to expedite strategic investments in people, programs and facilities. 

J.P. Gallagher. President and CEO of Endeavor Health (Evanston, Ill.): Through natural language processing, we are tapping into the power of artificial intelligence to mine our data, identify social determinants of health and feed that information back to our clinical teams at the point of care. We know that social determinants of health are among the biggest factors driving better health outcomes and promoting wellness in our communities. 

At the same time, we traditionally have limited knowledge about what these uniquely are for our patients because the vast majority of our data is in the form of unstructured clinical notes and a significant amount of time spent with patients is focused on treating an acute problem. Having this powerful knowledge about what is needed to treat the whole patient also allows us to connect them with additional support in their community like those organizations that are supported by our community investment fund.

We are also building on our leadership in personalized medicine with the introduction of Polygenic Risk Scores, which provides a window into patients' inherited risk of developing a broad range of conditions like cancer, diabetes or cardiovascular disease. Family history is an important indicator, but not everyone knows their family's medical history, and the information can be fragmented or incomplete. With the information provided through PRS testing, patients can be even more proactive about their healthcare through tailored screening, prevention and lifestyle changes.

Mike Young. President and CEO of Temple University Health System (Philadelphia): Our Temple Center for Population Health implemented a comprehensive approach to screening and responding to social determinants of health that advances health equity, partners with our communities, and improves the quality and delivery of our care. Patients are screened for social determinants such as inadequate healthcare access, financial instability, poor housing conditions, domestic violence, and food insecurity so that the most effective care strategies can be delivered to address them. Community Health Workers connect patients to resources and support. Community organizations, payers, and philanthropic groups develop effective responses. The program demonstrated significant reductions in ED visits and hospitalization rates for diabetes, asthma/COPD, and heart failure.

Joon Lee, MD. CEO of Emory Healthcare (Atlanta): We believe ambient listening technology has the capability to transform the clinicians' interactions with the patient and EMR. Being passive technology that can significantly decrease the workload of clinicians, it can impact the epidemic burnout we are facing in healthcare. At Emory Healthcare, in partnership with Abridge, we are making it available to a broad spectrum of clinical workforce including physicians, APPs, and nurses. With increasing and maturing application of AI, ambient listening technology can further automate multiple functions including coding, billing, prescription refilling, etc., thus increasing the overall efficiency of a complex health system. We are increasingly focused on innovations that can tie multiple functions together and improve the work experience for the clinical workforce.

Cliff A. Megerian, MD, FACS. CEO, Jane and Henry Meyer CEO Distinguished Chair at University Hospitals (Cleveland): Some of the most rewarding moments in medicine are when healthcare delivers to meet a pressing patient need. Last September, the FDA approved a therapy that was led by University Hospitals that's now giving hope to thousands of patients who suffer from chronic limb-threatening ischemia. These patients face loss of a limb, which in turn causes significant morbidities and the risk of an early death. Minimally invasive LimFlow provides an innovative new option, allowing 76 percent of patients to avoid amputation and experience wound healing. Mehdi Shishehbor, DO, MPH, PhD, President of our University Hospitals Heart & Vascular Institute and the Angela and James Hambrick Chair in Innovation, has been instrumental in this landmark moment for CLTI patients, lending expertise and co-leading the pivotal clinical trial. 

In fact, Dr. Shishehbor's passion for saving limbs builds on another innovative process he's been implementing for the past several years -- the Limb Salvage Advisory Council. By engaging diverse medical experts from across UH to thoroughly review and discuss each patient slated for amputation – quickly and in real-time – Dr. Shishehbor estimates he and his colleagues, which include vascular surgeons, endovascular and vascular medicine specialists, podiatrists and wound care experts, have saved thousands of limbs. 

The goal is clear: Every patient deserves at least a second or third attempt at restoring blood flow to the arteries to save the leg. The LSAC model at UH is unique in the U.S. Our vision at UH is to advance the science of health while employing the art of compassion. Dr. Shishehbor's leadership with LimFlow and the LSAC is a prime example of this -- a needle-moving innovation with impact that makes us all proud.

Christy Page, MD. Executive Dean of UNC School of Medicine and Chief Academic Officer at UNC Health Care (Chapel Hill, N.C.): We are committed to returning joy to practice and enabling our providers to focus on what they love to do – caring for people. We have increasingly found that artificial intelligence is an effective tool that can take some administrative burden off of our caregivers. This started with a pilot project that uses AI to draft responses to patient messages in MyChart. Now, we are utilizing an AI tool that listens to a patient appointment and can generate the provider's clinical note in only 15 seconds. All of this means that our providers can keep their focus where it belongs, on the patient. The best indication of the success of this was one physician sharing that she has not had to chart at home even once since participating in the pilots.

Elizabeth Wako, MD, MBA. President and CEO of Swedish Health Services (Seattle): We have a lot to be proud of in this area. We're committed to innovation as a cornerstone of our clinical excellence as well as our community work. One really bright highlight in this area is The Justice Unity Support Trust (JUST) Birth Network. JUST Birth was established at Providence Swedish to ensure that every birthing parent receives care from someone who understands their unique needs and experiences. 

We believe this model of care is essential to reducing the significant disparities in pregnancy and birth outcomes among Black and Native parents, which are well-documented here in our Puget Sound region and nationally. JUST Birth was envisioned with our community health partners as a resource by the community for the community. The network includes dedicated cultural navigators, childbirth educators, and birth and postpartum doulas who provide patients and their families with expert care and guidance throughout their pregnancy and postpartum journey. 

We know we are making a difference; analysis of initial data showed a reduced number of C-sections and an increased number of unmedicated births among Black parents who had the support of a Black doula during childbirth. In fact, JUST Birth is making such a difference that Biden Administration officials and a team responsible for innovation in Medicare and Medicaid services met this summer with JUST Birth leaders to learn more about the program and the broader application of its principles. I'd say that's moving the needle in a big way and in the way we're most committed to here at Providence Swedish.

David Sylvan. Chief Strategy and Innovation Officer of University Hospitals (Cleveland); President of UH Ventures: Earlier last year UH invested in and integrated a technology designed to remove or minimize financial barriers to care. The company, Tel-Aviv based TailorMed, uses its proprietary technology suite to ingest all of the necessary data to investigate available benefits; stratify the financial risks, and in near real time facilitate electronic benefits verification as well as the quantification of projected out-of-pocket expenses for the patient. The software then matches the patients with any available assistance, which not only accelerates access to needed care, but our ability to recoup some of the associated expense load. Truly a win-win for our most vulnerable patients and our system.

Nancy Howell Agee. CEO of Carilion Clinic (Roanoke, Va.): We've made many of the virtual care options introduced during the pandemic permanent and scaled digital services across all care. Patients appreciate the convenience of getting 24/7 urgent care from the comfort of home and we've seen month-over-month increases. It's expanded the footprint for our services, as well. Also, we hired "virtualist" primary care physicians who see patients solely online and, through the use of smart telehealth exam kits, created the capacity to deliver specialty care to our more rural communities where access is limited. The popularity of online appointment scheduling is steadily increasing, too.

Joseph Webb, DSc, MSHA, FACHE. CEO of Nashville General Hospital: The science of healthcare delivery has informed the creation and implementation of an innovative model of care management at Nashville General Hospital. We refer to the model as "Community Care Team." The CCT is composed of navigators (non-nursing), nurses, nurse practitioner(s), LCSW(s), social worker, and dietitian(s). The goal is to change the local culture of healthcare by engaging in a no-discharge structure and process whereby delivery of healthcare/wellness services is provided in the hospital, home, physician's office, or other post acute care settings. The provision of services is aligned with the mission of NGH and population health needs of Nashville and the Davidson County community. 

We continue to diversify our methods of capturing patients that will benefit from the program which includes faith-based initiatives. Our goal is to reduce unnecessary ER visits and hospital readmissions by facilitating self-management care and maximizing utilization of community resources. We identify high-risk patients through a high utilizer registry report that indicates patients with potential avoidable utilization (PAU). 

Additionally, inpatient case managers identify social determinants of health for at-risk patients using the PRAPARE screening tool. These patients are risk-stratified using the High-Risk Assessment (HRA) tool and are subsequently exposed to a treatment regime that is conducive to improving their health outcomes based on unique risk factors and healthcare needs. The CCT is a 24/7 team that supports all patients across the continuum of care regardless of their socioeconomic status, race, ethnicity, or language.

Brad Reimer. Chief Information Officer of Sanford Health (Sioux Falls, S.D.): At Sanford Health, we are investing in new technologies to address staffing shortages and create a more meaningful experience for our teams. For example, over the last year, we launched a 70-plus room AI-powered "smart hospital" pilot to reduce administrative burdens for our nursing staff, increase productivity and improve patient care quality. Not only is this pilot moving the needle in these important areas, but it has also sparked a conversation around innovation and technology at the bedside like we've never seen – a win-win for our teams and our patients.

Jared Antczak. Chief Digital Officer of Sanford Health (Sioux Falls, S.D.): One of the most needle-moving innovations we have rolled out in the past year at Sanford Health has been our patient digital registration experience. We launched a convenient and frictionless self-service option for our patients to prepare for an upcoming appointment with their provider, which has been a win-win for our patients and workforce. 

During 2023, we had more than 1.4 million visit registrations completed through our new digital experience. This has created thousands of hours of capacity per month for our teams, alleviating pressure and allowing them to maximize their time by focusing on more patient-centered services. 

In addition, the tool has a 95.6% patient satisfaction rating and has reduced clinic no-shows by 20%. Patients now have a more seamless way to pay bills online as well. This is one of several digital transformation initiatives that we are leveraging to holistically address people, processes, and technology for the mutual benefit of our patients and our workforce.

Jeremy Cauwels, MD. Chief Physician of Sanford Health (Sioux Falls, S.D.): At Sanford Health, creating a culture of safety has made a tremendous difference for our teams and patients. Our high reliability program known as SAFE has moved the needle by strengthening trust and transparency across our organization, building more resilient and empowered teams and improving care outcomes. 

People choose to work in healthcare because they want to make a difference. Our teams now come to work every day knowing everyone is accountable for safety and that their voice matters. They also understand the positive impact of their actions on the lives of others. Through consistency, accountability and delivery of competent and compassionate care, our high reliability program has become an enduring cultural pillar for our organization and has improved safety and quality outcomes for the patients we serve across the upper rural Midwest.

Matthew A. Love. President and CEO of Nicklaus Children's Health System (Miami): At Nicklaus Children's Health System, we are continuously leveraging technology to provide innovative solutions that improve the lives of our patients, their families, and our staff. An example of an innovation we implemented this year is the fully immersive patient bays in our hemodialysis unit, giving patients the ability to control their surroundings. 

Through a digital control panel, patients can change their surrounding lighting, music, play games, and engage in group karaoke. Another example is our DRIVE Program, where we have successfully helped over 20 neurodiverse young adults learn to drive by incorporating a fully immersive virtual reality. For our staff and patients, we have an AI chatbot that navigates through reams of data to provide real-time information about our health system's clinicians and services. As new technologies become available, Nicklaus Children's will continue to expand our offerings to ensure that patients, families, and staff have the latest advances to support their care journey.

Steve Davis, MD. President and CEO of Cincinnati Children's: This is not an easy question as we have rolled out several different innovations at Cincinnati Children's in recent years that have had significant impact and a few others that will likely have impact in the coming years. One of the most impactful innovations in the past couple of years is the pioneering use of virtual reality technology to aid in complex surgical planning. 

Our Heart Institute physicians are changing the paradigm for surgical planning by harnessing the power of virtual reality to visualize the heart and related structures in three dimensions. The surgical team can explore and interact with the heart to identify potential challenges and optimize surgical strategies. The ability to virtually "walk through the heart" offers views of key structures not possible with standard approaches, enhances decision making, reduces risks and enhances patient safety. It can also be used to help explain the surgical process to the patient and family. This has allowed them to offer options to patients who have been to other heart centers and turned down for surgery. The use of VR technology has many applications beyond cardiac surgical planning and is already spreading to other surgical areas. 

Chanda Chacon. President and CEO of Children's Nebraska (Omaha): Moving the needle at Children's Nebraska is always about improving multiple outcomes. This past year, the implementation of 3D printing and VR modeling technology has significantly reduced surgical times (by up to 50%) and improved patient outcomes. Children's has one of the best 3D and advanced practice programs in the country. By leveraging 3D tools, our surgeons can better visualize complex procedures and plan surgeries with incredible precision. This innovation has not only enhanced the efficiency of surgeries but also contributed to a higher level of safety and efficacy in pediatric medical interventions.

Peter Pronovost, MD, PhD, FCCM. Chief Quality and Clinical Transformation Officer; Veale Distinguished Chair in Leadership and Clinical Transformation of University Hospitals Cleveland: Like all health systems, we at University Hospitals are always looking for innovative ways to provide high-value care to our patients, while ensuring hospital access for our sickest patients and managing costs. In many cases, this is easier said than done – but not always. A needle-moving innovation we unveiled this year does both things: our new Healthy at Home program. Tailored for patients with conditions like COPD, pneumonia and cellulitis, it allows us to deploy a variety of services and be flexible in meeting patients' needs.

The model usually begins with a paramedic visit and includes home health, a tele-physician or nurse visit as needed, and can sometimes include infusion of medications. We now have an average census of about 80 patients a day. That means 80 people who might otherwise be in the hospital are not only being compassionately cared for in their homes, but are now receiving high-quality care at a lower cost. Our hospitals are normally full, as many are, but now we're freeing up beds to enhance access for cancer patients and high-risk surgery patients who need timely inpatient care. This innovation is a testament to what's possible when thoughtful strategy and purposeful collaboration among different groups of caregivers unite for a singular purpose: keeping people healthy at home.

Charles Powell, MD. CEO of Respiratory Institute at Mount Sinai Health System (New York City): In reflecting on the lessons gleaned from the 2020 pandemic response, two pivotal insights emerged: the profound clinical impact of remote patient monitoring and the critical importance of swiftly disseminating actionable inpatient monitoring data, especially for those in critical condition.

Leveraging the expertise and tools honed during the pandemic, we have successfully implemented two innovative approaches utilizing clinical decision support platforms. These initiatives have elevated the quality of clinical care for both outpatients with chronic obstructive pulmonary disease and critically ill patients grappling with respiratory failure.

1. A remote monitoring program for COPD patients has been activated in the health system. This program employs passive physiologic data collection, channeling information to a home cellular transmitter. The transmitted data is then directed to our central monitoring station, staffed by clinical pharmacists adept at navigating collaborative escalation pathways for a spectrum of clinical scenarios. This platform has demonstrated its efficacy in reducing COPD readmissions, demonstrating a tangible improvement in care quality.

2. Simultaneously, we introduced a comprehensive systemwide mechanical ventilator dashboard. This dashboard acquires real-time ventilator data, relaying actionable insights on crucial parameters such as tidal volume, respiratory pressures, and gas exchange. This data is seamlessly integrated into the Epic EHR and disseminated to individual subscribers with clinical roles in the care of critically ill patients. The implementation of this dashboard has resulted in a significant increase in compliance with recommended mechanical ventilation practices for patients grappling with respiratory failure, thus further enhancing the overall quality of care.

Together, these innovative measures have significantly improved the quality of care provided to both COPD patients and those in critical conditions. The reduction in readmissions and increased compliance with ventilation recommendations underscore the tangible impact of these clinical decision support platforms in healthcare delivery.

Robert Calway. President and CEO of New England Life Care (Scarborough, Maine): We have been seeking opportunities to introduce artificial intelligence and robotic process automation applications to improve efficiency, quality, and productivity. We introduced an RPA process that automated the import of home infusion pharmacy orders from the hospital post-acute referral process. This improvement significantly reduced labor demands for the manual re-entry of previously faxed orders, dramatically reduced errors associated with transcription, thereby improving patient safety, and increased the productivity of staff who previously were responsible for this "mundane" but important activity. This innovation was a home run!

Eric Tritch. Vice President of Supply Chain at UChicago Medicine: While we are running exciting pilots involving RPA, AI, new supply room technology and physical autonomous delivery robots, the biggest needle mover over the past year has been implementing a more robust forecast accuracy planning process with our supply distribution partner, Cardinal Health. This isn't a new concept, but spending time really drilling into how our forecasts matched reality and actions we can take to drive better accuracy and less variance (high or low) in the future is fundamental work that has a big impact on fill rate accuracy and cost control and we are seeing the impact.

Jose Lopez, MD. Chief Medical Officer of Holy Cross Health Florida (Fort Lauderdale): During the pandemic and beyond, the population of South Florida has grown significantly. As a result, we have responded to the increasing demand by attracting community physicians and expanding our medical group. This has allowed us to address access and service line gaps to serve our patients better.

Donna Jones, RN. Chief Quality Officer of Erie County Medical Center (Buffalo, N.Y.): An intentional focus aligning organizational culture with the mission of our organization. We've gone back to the beginning again for a reset of our tiered-daily huddle process in an effort to enhance our safety culture.

Susmita Pati. Chief, Primary Care Pediatrics; Chief Medical Program Advisor, The Alan Alda Center for Communicating Science at Stony Brook University (N.Y.): The most needle-moving innovation our team has rolled out in the past year at Stony Brook Medicine are two programs to support healthcare workers: our Alda Healthcare Experience team communication workshops and our Single-Session Support Center. 

Our Alda Healthcare Experience team communication workshops leverage the power of improvisational theater exercises to build healthcare team communication skills, foster team cohesion, and promote a positive organizational culture. Rigorous scientific evaluation of this program is showing positive impact among nearly 500 diverse health care professionals at Stony Brook Medicine. 

Complementing these efforts, our Single Session Support Center offers healthcare professionals virtual and in-person support during times of acute need. Individuals have the option to independently and anonymously complete a web-based session that is proven to alleviate mild depression and anxiety by promoting a growth mindset. We are proud to share lessons learned from these initiatives to support psychological safety for our healthcare workforce so that we can continue to work together to provide the highest quality care for our patients.

Anthony Aquilina, DO. Executive Vice President and Chief Physician Executive of WellSpan Health (York, Pa.): Probably the most exciting work has been with artificial intelligence in digital diagnostic applications. Examples include AI improved intracranial hemorrhage detection and pulmonary embolism identification. In total we have 14 specific areas of AI enhanced clinical diagnostic processes. Additionally, we have initiated virtual nursing and sitter programs in several of our hospitals. Through that program we already can show improved safety as well as better patient and staff satisfaction.

Kim Bennion. Director, Respiratory Care Research of Intermountain Health (Salt Lake City): In 2016, we implemented pulmonary disease navigators to facilitate the care of chronic obstructive pulmonary disease and adult asthma patients. Key goals were to provide the right care to the right patient at the right time and in the least expensive setting…often the home. After 18 months of coordination with a company who created and maintains an artificial intelligence platform as well as three other companies who developed blue-toothed enabled remote patient monitoring devices specific for chronic lung diseases. 

Utilizing the evidence-based PDN protocols for COPD and adult asthma as well as validated surveys questionnaires, patients are monitored daily by the PDNs for symptoms denoting an exacerbation. This will allow the PDNs to identify the start of worsening symptoms earlier and increase healthcare oversight access by providing care to 250 versus 50 patients a month with our previous manual process. 

More timely identification of exacerbations leads to earlier therapeutic interventions, inpatient admission prevention, and greater patient satisfaction. What consistently follows doing the right care at the right time, is a drop in cost of care.

As we continue our study for two years, we are confident the outcomes will support the concept that an "ounce of prevention is worth a pound of cure." A pulmonary disease care management and population health tool of this sort has not been found in the over 20 care management tools we have reviewed. Our team considers itself honored to be a part of its creation and privileged to have found such phenomenal partners for our journey.

Matthew Painter. Director of Leadership Development at UAB Health System and School of Medicine (Birmingham, Ala.): Recognizing that healthcare is a team endeavor, we've intentionally invested in the effectiveness of our interdisciplinary teams. We piloted a High Performing Care Collaborative intensive leadership boot camp that focuses on applying leadership and management principles in a team environment. Participants attend with their core team and develop a comprehensive action plan. We are currently exploring ways to utilize this model with specialty clinical and non-clinical teams as well.

Tipu Puri, MD, PhD. Associate Chief Medical Officer of University of Chicago Medicine: Over the past year we have focused on being as intentional as possible in the placement of patients in our inpatient beds and hospital units. As a result all members of the multidisciplinary care team are able to interact and engage with their patients and with each other more frequently during the course of each day. This effort has supported building stronger multidisciplinary teams, enhanced communication, better efficiency, ease of practice and workforce satisfaction, and improved patient experience. As a teaching institution we have also seen a positive impact on our educational mission and the experience of our students and residents.

Tahlia Weis, MD, PhD. Surgical Services Medical Director of Marshfield Medical Center (Wis.): One of the biggest challenges across all realms of healthcare is staffing. In a rural health setting, recruitment is challenging and lack of proficient team members is disabling. Our system has made effective moves towards the development of "Train and Retain" programs, from medical assistants to vascular and surgical technologists. In the last few years, we've additionally started cardiology and vascular surgery fellowship programs for physicians and are invested in developing APC fellowships for additional specialty training. The objective is always to provide world class healthcare in a rural environment. We will continue to do so by investing in the education of our local workforce.

Tanira B.D. Ferreira, MD. Chief Medical Officer of University of Miami Hospital and Clinics; Associate Professor of Medicine, Pulmonary, Critical Care and Sleep Medicine Division at University of Miami Miller School of Medicine: This is a fast-paced topic. Innovation is a natural extension of our ongoing focus to lead the incorporation of technology that can benefit our patients. New technology and new tools are wonderful, but we still need to apply scientific rigor to every new therapy or outreach to our community, which is part of our academic mission. In addition, as we apply such technology, we need to be mindful not to take time away from the bedside care.

In my role as CMO we have implemented a variety of tools focusing on patient quality and safety, for instance video monitoring room to reduce falls; high risk readmission prediction tool; AI with early identification of pulmonary embolism and activation of PERT team (pulmonary Embolism response team); AI to improve accuracy of the severity of illness as physicians document in the EMR.

Jonna Jenkins, DNP. Vice President of Patient Care Services and Chief Nursing Officer at Hutchinson Regional Medical Center (Kan.): The most needle-moving innovation my team has rolled out in the last year is the creation of a simulation unit within our hospital in conjunction with our local community college. An actual nursing unit in our hospital has been turned into a simulation lab including 8 high fidelity mannequins including 4 general purpose, 1 critical care, 1 OB, 1 infant, and 1 child. 

The partnership with the community college is a strategic partnership to grow our pipeline of not only nurses but all allied health professionals. Additionally, the ability to train our team of healthcare professionals in a controlled environment will allow them to be more prepared to care for the individuals in our community. We are developing a new role for a simulation educator to join our team so we can utilize this state of the art technology long into the future. 

Giovanni Piedimonte, ​MD. Vice President of Research, Institutional Official, and Research Integrity Officer at Tulane University (New Orleans): Leading the artificial intelligence task force at Tulane is a lot of work, but also a great opportunity because it's been pushing me to look at all the facets and angles of the incredible opportunities and dangers that are associated with generative AI. In a way, it feels like when J. Robert Oppenheimer was confronted with the supernatural power and unfathomable risks of nuclear energy and began understanding that the new technology could create a brand-new world or destroy it. It's been a very interesting experience, but it's just the beginning, so it's impossible to predict where this journey will take us. I hope our team will be able to master the more productive aspects of this incredible technology while trying to avoid some of the problems.

Ken Dunham, MD. Executive Director of Medical Operations and Behavioral Health at Sentara Health (Norfolk, Va.): Like many facilities, our EDs were seeing year over year surges in patients with behavioral health needs. Our team at Sentara had to redesign how we take care of patients with behavioral health emergencies in our emergency departments. We created an in-house physician driven, therapist staffed centralized telepsychiatry emergency response service that proactively coordinated and worked consultations in our emergency departments. 

We included a health system employing therapists and psychiatrists and partnered with a telepsychiatry vendor to quickly scale to our needs. Because of these innovations, we were able to reduce ED BH length of stay by about 13% despite an increase of volume of 18%. We predict the volumes to continue to increase, so this is a never-ending battle. We continue to work to innovate how we proactively assess, stabilize and disposition patients seeking BH care in our facilities to include ED and inpatient alternatives by partnership and by our own build.

Deana Sievert, DNP, RN. Chief Nursing Officer of The Ohio State University Wexner Medical Center (Columbus): Here at The Ohio State University Wexner Medical Center we have really leaned into our "team of teams" model, specifically triads and dyads. For example, by pairing a department leader, such as a nurse manager, with a physician leader who is the medical director of that department to create a dyad, we are able to drive our quality and safety agenda and necessary change. Obviously, most clinicians have a heart to improve patient outcomes and patient safety. By putting these two leaders together to push the organizational strategic plan and operational goals at the department level we are creating synergy to best drive change and institute accountability.

Linda Stevenson. Chief Information Officer of Fisher-Titus Health (Norwalk, Ohio): Given the status of healthcare finances, our technology team is working hard to offer ways to improve revenue, reduce cost and streamline the work. Fisher-Titus has been exploring the use of Microsoft/DAX Co-Pilot for our physicians as one of those initiatives. We focus on partnering with our vendors to take advantage of the latest technology, and this was one that we wanted to evaluate right away. This pilot group of physicians are using this to streamline their patient visits and give more of their attention to the care of the patient. We are also exploring the Microsoft CoPilot solutions to improve the productivity of our management team, along with investigating opportunities that AI can bring to improve our revenue cycle processes. 

Athena Minor. Chief Nursing and Clinical Officer of Ohio County Healthcare (Hartford, Ky.): Our population health program has undergone some major expansion over the past year. As an organization, when we joined our ACO several years ago we made the determination that what was good for our Medicaid and Medicare populations was good for all of our patients. From the beginning, our plan of action to reduce healthcare costs for our attributed lives has been extended to our entire patient population. We have a wonderful population care team who have been able to collaborate with many community partners and obtain resources to meet identified needs throughout our community. 

This past year we have restructured our population health program. One of the innovations we have implemented is obtaining certification for our social workers as community health workers. We have also implemented a process that has given them the autonomy to address immediate SDOH issues as appropriate while navigating patients through the complex system of care for services and resources that meet their specific needs. This has greatly impacted readmission rates and created better transitions of care, especially for our chronic care management patient population!

John Hamiel. Director of Pharmacy of MercyOne Waterloo (Iowa) Medical Center: The most needle-moving implementation we have rolled out this year is the starting of a closed door specialty pharmacy. It is run out of our current community pharmacy based in our hospital. Though we have just started the process we are anticipating a huge decrease in wait time for patients to start therapy and an increase in patient and provider satisfaction.

Jonathan Berkowitz, MD. Medical Director of Emergency Telehealth, EMS and Transfer at Northwell Health (New Hyde Park, N.Y.): Our virtual front-door acute care service, Northwell Emergency Telehealth Services, continues to transform our healthcare approach. We've extended our reach to nursing facilities and emergency departments, as well as created specialized programs for geriatric and oncologic patients. The expansion of our direct-to-consumer service, ER on Demand, now spans multiple states. We are making significant strides in improving patient experience, reducing readmissions, enhancing throughput, and ensuring sustainability.

Ebrahim Barkoudah, MD. System Chief and Regional Chief Medical Officer at Baystate Health (Springfield, Mass.): The introduction of quality and safety dashboards stands out as the pinnacle of innovation in healthcare delivery, with far-reaching impacts on the efficiency and advancement of value-based care. These dashboards utilize the full spectrum of real-time data analytics, revolutionizing how we assess, monitor, and ameliorate patient care safety and quality. 

Integrating such sophisticated analytics into daily operations translates to tangible benefits — notably, an agile environment where the decision-making process is greatly expedited, fostering a system where swift, data-informed actions are the norm. This improves the efficacy of responses to changes in patient care requirements, leading to a dynamic improvement in overall healthcare processes. Its multifaceted capability to transform various aspects of healthcare delivery is at the core of why this innovation is so impactful. Leveraging real-time monitoring capabilities means potential issues can be swiftly pinpointed and resolved, circumventing the delays of traditional retrospective analyses and ensuring consistent adherence to the highest care standards. 

The dashboards have made great strides in efficiency by automating the tedious tasks of data collection and reporting, thus reducing the burden on healthcare staff and freeing up their time to focus on direct patient interactions. Beyond mere operational improvements, these innovations directly support the shift towards value-based care by facilitating rigorous tracking of key performance indicators linked to health outcomes, patient satisfaction, and cost-effectiveness. 

What's more, the approach will empower frontline providers with the means to enhance patient outcomes through continuous monitoring of crucial health metrics, boosting transparency and accountability across the board. Adaptable and scalable, the dashboards are designed to meet specific departmental needs while providing a view for overarching organizational insights, setting a new standard in patient care and information management.

Rebekah Compton, MBA, DNP, FNP-BC. Chief Clinical Officer of The University of Virginia (Charlottesville): Developing a robust onboarding process and mentorship program for our new providers.

Daniel I. Simon, MD. President of Academic & External Affairs; Chief Scientific Officer; Ernie and Patti Novak Distinguished Chair in Health Care Leadership at University Hospitals Cleveland: As pioneers in advanced imaging for procedural planning in structural heart disease, University Hospitals has innovated the use of cardiac CTA and MRI to make left atrial appendage closure (LAAC) safer, more efficient and more successful. The success rate of LAAC at UH is 99.7%, which is among the very best in the country. More than 95% of patients are discharged home on the day of the procedure. In fact, UH has the largest published experience in same day discharge after LAAC. UH also has the lowest rate of device leak and device related thrombus published to date. Taken together, UH has become one of the top implanting sites in the U.S. due to its success and excellent outcomes.

Michelle Holm, PharmD, MPH. Senior Pharmaceutical Contract Portfolio Manager and Supply Chain Management at Mayo Clinic (Rochester, Minn.): Inspirity: Launching Inspirity Health Partners for institutions interested in the opportunity to collaborate versus merging with another hospital or being acquired is our most needle-moving innovation. We launched Inspirity in 2023 and are actively working with clients. Through Inspirity, Mayo Clinic brings the best of the best supply chain management and pharmacy acumen to analyze opportunities to help lift institutions financially and operationally. 

Working collaboratively with the institution using shared decision-making facilitates implementation of creative approaches during a long-term partnership. This innovative approach is new to the market and provides an avenue for institutions interested in guidance and support while maintaining the independence of their institution.

Joanna Perdomo, MD. Physician of Pediatric Care Center at Nicklaus Children's Health System (Miami): This year, we are rolling out a systemwide social drivers of health screening and referral system, in which we ask questions about food, nutrition, housing, utilities, transportation, and overall resource needs. We have already piloted this initiative in five clinical areas and found that 40% of patients have screened positive for a need in at least one domain, and 30% have screened positive for food insecurity. We believe that the ability to identify needs and most importantly connect families with necessary resources is hugely impactful on patients' and families' overall health and wellbeing.

Vi-Anne Antrum. Senior Vice President and Chief Nursing Officer of Cone Health (Greensboro, N.C.): We have many innovations that took place over the last year at Cone Health! The most needle-moving innovation I've rolled out in the past year is through an AI partnership with Lirio around hypertension. One of our cardiologists, Dr. Tiffany Randolph, helped spearhead this initiative. We co-created a hypertension module to help engage under and/or disengaged patients in the communities we serve. 

Lirio utilizes precision nudging backed by behavioral science to help us achieve our value-based care and health equity goals at Cone Health. Additionally, this product will be available for purchase to assist other health systems with the new regulatory requirements for health equity measures. Our rate of hypertension control for all patients greatly exceeds the national average. We are proud to share our innovative clinical care with other health systems around the nation so they can realize similar results!

Pooja P. Vyas, DO. Vice President and Chief Medical Officer of Christian Hospital Northeast & Northwest Healthcare (St. Louis): What really moved the needle for us in 2023 was changing the way we looked at our case manager and social worker roles. Our teams wanted to improve our length of stay, so we thought of ways to find innovative roles that could help us target the core causes of our length of stay being off. 

We created the contemporary care model, and helped to align our case manager and social worker roles to their education and expertise. We improved our ratios, and we also helped our teams develop leadership skills to be accountable to their roles from progressing the patient, managing cost of care, and planning safe discharge transitions.

Terrie Edwards. Corporate Vice President of Sentara Healthcare (Norfolk, Va.): In 2023, with a new system CEO, Sentara Health transitioned to a "One Sentara" mindset. The health plan division moved its products to one name: Sentara Health Plans. The business operations were organized into Care Delivery (acute care, ambulatory care) and the Health Plans. Where beneficial, services were realigned and the change allowed for elevated planning for all three divisions. It has been transformational to have our leaders more intentional in making decisions with the understanding of the integrated impact for our consumers. 

Fredric A. Reyelts, MD. Medical Director of Innovation at Trinity Health Medical Group (Livonia, Mich.): In order to address the current staff shortages plaguing many primary care offices, I developed a process to leverage a medical assistant virtually. By engaging patients in providing their HPI via a portal, using a self-check-in process, in-office wayfinding, and technology to self-collect vitals, I was able to significantly reduce the cycle time for "rooming" a patient. This allowed the MA to more than double their productivity and even support another provider/office remotely.

Kiyana Turner. Director of Digital Transformation at Children's Hospital Los Angeles: The innovation product where I'm most excited to see impact is our ED care companion experience. We've rolled out a web- and text message-based experience (no app download required) that we're calling CHLA "MyVisit" that uses AI to provide patients and families an estimate of their expected wait times, guidance through each phase of their ED visit, explanation of test results, ability to ask questions, wayfinding and resource navigation around the hospital, and much more. 

Patients can easily share their visit progress with family members and after discharge, patients receive a digital summary they can share with their pediatrician or primary care provider. In the throws of cold/flu, COVID, and RSV season, our ED has been inundated with patients. We're excited to provide our patients and families with better communication, increased transparency and visibility into their care journey, and overall a better patient experience. Following the rollout in the ED, there is also potential to expand to other clinical areas for improved expectation-setting and care journey navigation.

Annie Thomas-Landrum, MSN, RN. Board of Directors of Sunshine Community Health Center (Talkeetna, Alaska): For our clinics, the biggest innovation has been really incredible courage on the part of our CEO and the team he is leading. When Joshua Gilmore came in as CEO, our Community Health Center was facing some incredibly huge obstacles. Financial, workforce, community rapport, pandemic recovery, the list goes on. Over the last year, I have seen Joshua act with courage in four key areas:

1. The courage to embrace reality: As a new CEO, Joshua led the team in taking a deep dive into the realities we were facing. He did this through a very focused look at where our money was going and what we were getting for it, where the money wasn't coming in but it should be, where our relationships stood, within the clinics and with the community we serve, and where our voice was and wasn't being heard in the bigger conversations. And he didn't argue with that reality. He embraced it. 
2. The courage to form strategic partnerships: Joshua and the team started looking for practical and innovative ways to address the realities we were facing. They have looked for those creative solutions through partnerships nationally, at the state level, and at the local level. Through these strategic partnerships, he created an opportunity for courageous move #3...
3. The courage to make the big asks: Joshua and his team have found funding never before available because they had the courage to ask, coupled with the wisdom to know how to make the argument. Solid numbers, clear outcome measures, compellingly presented need and the demonstrated ability to meet it with the right resources...the team assembled all this, and continuously made relational investments that allowed for chances to present it to committed partners. Because of this, our clinic is financially stable in a whole new way. 
4. The courage to connect directly with those we serve: This is a big one. All the funding in the world means nothing if the community doesn't trust us. Like many healthcare organizations, the pandemic left us with a lot of strained relationships. That can be pretty hard to face. Joshua and his team have been consistently running right towards the uncomfortable conversations, willing to listen, willing to act, and willing to keep trying, even when it's hard. 

Sometimes, the biggest innovations are just the basics that ground us back to who we are and who we do it for. I am so excited about the huge moves our team has made doing just that.

Majid Tanas. Vice President and Chief Pharmacy Officer of Legacy Health (Portland, Ore.): Being a health system requires maximizing the impact of the pharmacy enterprise is essential. We've implemented cost containment measures on inpatient, improved ambulatory pharmacist billing, and increased internal prescription capture and 340B utilization.

Celina Cunanan, MSN, APRN-CNM. Chief Diversity, Equity and Belonging Officer at University Hospitals (Cleveland): University Hospitals has been actively addressing food insecurity in our region since 2018. This past year we opened our fifth UH Food for Life Market®, a food-as-medicine preventative model that addresses chronic health conditions by providing free, healthy food, nutrition coaching and counseling, and free cooking lessons at our teaching kitchens. 

The UH Food for Life Markets® differ from a food pantry in that the food provided is tailored to address the medical needs of the patient by an onsite dietitian. Since opening the first UH Food for Life Market® in 2018, hypertensive patients who were referred to the market saw a decrease in blood pressure; pregnant women experienced less excess weight gain; and diabetic patients saw improved A1C scores. Going forward, we plan to open two more UH Food for Life Markets® this year. With these current efforts, and our plans for expansion over the next five years, our commitment to address food insecurity is estimated to total approximately $18 million. 

Tami Minnier, MSN, RN. Senior Vice President of Health Services Division and Chief Quality and Operational Excellence Officer at UPMC (Pittsburgh): UPMC established a new model of care that includes the role of a discharge plan manager to be fully accountable for all aspects of the patient's care coordination and discharge plan from hospital admission through post-acute care. The model required establishing a new Clinical Care Coordination & Discharge planning team, bringing social workers and care managers together into common job titles and career ladders and cross training the team on the expanded job responsibilities for alignment and efficiency. The model aims to reduce hospital length of stay and readmission rates and enhance the patient experience. 

This model has strengthened patient-centered care through reducing unnecessary blood draws, decreasing time on IV antibiotics, increasing patient satisfaction, and ensuring that patients receive a post-discharge phone call from a familiar person who knows them best. This new model of care was rolled out to 20 hospitals and in the first year UPMC saw a 5.2% increase in HCAHPS care transition scores and 43.4% decrease in average length of stay for complex care patients. In addition to patient benefits, employees now manage smaller caseloads and are offered alternative shift assignments for more flexibility in work hours. 

Over 220 hours were saved each month by eliminating face to face documentation for home care services. The development and launch of a Care Transitions Management web portal streamlined communication between our discharge plan managers and home care agencies resulting in an estimated time savings of up to 304 hours per discharge plan manager each year. This new model of care was established to do the right thing for our people: our patients and our employees who care for our patients.

Sachin K. Gupta, MD. Chief Medical Officer of UNC Physicians Network (Durham, N.C.): Over the last year, I'm most proud of the establishment and growth of our Onboarding and Optimization team (The O2 team). This team is responsible for three large bodies of work. The first is creating a seamless experience for all of our clinicians who are onboarding to UNC Physicians Network. This includes at-the-elbow Epic support, template customization, workflow optimizations, preference list build outs and so much more. 

Clinicians are ramping up faster as a result. The second is centralized in-basket work. This team is responsible for leveraging standing orders to handle medication refill requests and results notes to unburden clinics from this work. To date, they have handled over 150,000 messages and have resulted in nearly 10,000 hours of work being removed from the clinics. The final body of work is around scribing. The team onboards and trains scribes and we currently have scribes spanning 11 different specialties helping to improve efficiencies and improve clinician well-being.

Robert J. Corona, DO, MBA, FACP. CEO of Upstate University and Community Hospitals (Syracuse, N.Y.): The most needle moving innovation has been the opening of our "Connect Care" service. It is a clinic that sees lower acuity cases and thus it is effective at helping to decant the volume in our emergency room.

Results:

1. It has significantly reduced the number of patients who left without being seen in all 3 of our hospital emergency rooms. 

2. It has lowered the average time to complete an ER patient visit as patients can be triaged to the Connect care clinic

3. It has helped reduce the average boarding time in the emergency room.

Nygel Williams, MHA, CHFP. Executive Director of Physical Therapy Program at Washington University School of Medicine (St. Louis): Over the past year, we worked hard on the integration of our physical therapy clinical assistant and faculty into our educational activities within the physical therapy program here at Washington University School of Medicine as a part of our first in the nation competency-based curriculum. 

Recognizing the evolving landscape of healthcare, we strategically implemented a comprehensive program that pairs our first-year learners with seasoned clinical associates and faculty, providing invaluable real-world experience and mentorship. This initiative not only enhances our students' clinical skills but also fosters a dynamic learning environment, ensuring that our program continues to produce top-tier physical therapy professionals ready to excel in diverse healthcare settings. This is critical as usually learners don't get that in clinic experience until much later in their program, here we are working to get them in front of patients early to help foster both mentorship and accelerate the learning in the clinical environment.

Melisa Adkins, EJD, MBA, BSN, RN. CEO of UofL Health - Mary & Elizabeth Hospital (Louisville, Ky.): My team and I have rolled out two needle moving service lines over the past year. In fact, they are both still under construction. The first is the 33-bed medical behavioral health unit and the second is a new obstetrical/midwifery unit called, The Birthing Place.

The medical behavioral health unit will provide both the medical and behavioral care to our patients in one visit. This is extremely important since most behavioral health facilities provide care for behavioral issues only. 

Acute medical issues are not accepted and have to be transferred to an acute care facility which may not have the ability to treat medical and behavioral needs at the same time. This puts the patients and the staff at risk. Providing an environment with experts in both fields that will treat both mind and body is what every community needs when medical issues arise in a behavioral health patient.

In Louisville, Kentucky, UofL Health's Mary & Elizabeth Hospital is the only hospital west of I-65. The lack of access to women's services has been a real issue for many years. UofL Health has taken a stance to get behind creating better access for all which will include providing the options of either a holistic or a more traditional approach to delivering a child. Our own Louisville Metro Council city government officials also believed in the cause and gifted $8.25M towards the $20M project with UofL Health adding the additional $11.75M. Closing gaps in healthcare and correcting inequities is our duty as healthcare providers. This project shows the commitment our organization has to improving the health and wellbeing of all we serve.

Madeline Camejo. Chief Pharmacy Officer and Vice President of Pharmacy Services at Baptist Health South Florida (Coral Gables): In the country the discussion surrounding weight management has gained significant traction, particularly in the past year due to new medications and treatments now available in weight management. This period has presented us with a remarkable opportunity to establish an integrative approach to health, specifically focusing on weight management, ensuring that comprehensive care is readily available.

At Baptist Health South Florida, an innovative aspect of our approach has been the certification of our ambulatory pharmacist as wellness coaches. 

This initiative not only elevates the quality of care provided but also bridges gaps in conversations pertaining to exercise, nutrition, sleep, and individual goal setting. It's imperative that these discussions encompass cultural and social determinants, recognizing their profound influence on personalized care. Through a systematic approach and standardized workflow, we aspire to ensure that all patients and employees receive consistent, comprehensive care across the entire system to improve overall health and wellbeing of our patients.

Toi Harris, MD. Senior Vice President and Chief Equity, Diversity and Inclusion Officer at Memorial Hermann Health System (Houston): In the past year, the Memorial Hermann Institute for the Advancement of Health Equity was launched to directly address the complex health equity challenges prevalent in Houston across the U.S. The Institute focuses on research and innovation to address key social determinants of health, including education, income, community safety and access to health care, to reduce health disparities. 

Health inequities cost the U.S. an estimated $320 billion annually, a number expected to rise to over $1 trillion without intervention, impacting health care affordability, quality and accessibility. The Institute embodies a strategic commitment to health equity, proactively responding to a growing crisis by implementing value-based strategies aimed at enhancing community well-being. This initiative represents Memorial Hermann's longstanding commitment to meaningful community health improvements.

David Verinder, MBA. President and CEO of Sarasota Memorial Health Care System (Fla.): In February, we celebrated the "topping out" of our new Kolschowsky Research & Education Institute. The age-old ritual signifies the construction project has reached its maximum height and represents a significant milestone for our health system and community. When it opens next year, the state-of-the-art training facility will expand our research capabilities and create a collaborative learning environment that attracts top-tier researchers and physicians and brings advanced treatments to our rapidly growing southwest Florida region.

J.R. Greene. CEO of Psychiatric Medical Care (Brentwood, Tenn.): Psychiatric Medical Care provides behavioral health services to hospitals and health systems across the country, including a hospital-based, outpatient program for older adults called Senior Life Solutions. We struggled to find a documentation system that would meet the needs of our hospital partners and our regulatory requirements. So, in 2023 we created our own HIPAA-compliant web application to manage clinical documentation. We call this new application 'Insight.'

It's given our clinical team increased oversight, and improved transparency across our systems and the hospitals we partner with. Insight also made our documentation processes more efficient for physicians, clinical staff, and our corporate team. The next phase for this innovative new tool is the development of reporting capabilities around billing, and an interface with our outcomes management system to help us track and improve patient outcomes.

Marva Williams-Lowe. Chief Pharmacy Officer of Medical University South Carolina Health (Charleston): A significant workforce challenge for healthcare systems is the shortage of technicians. This shortage includes pharmacy technicians. The U.S Bureau of Labor statistics expects a 5% growth in pharmacy tech jobs by 2031. The shortage is expected to continue with technicians leaving current roles to move to other jobs and to retire. Pharmacy technicians perform crucial functions for pharmacies in support of day-to-day operations and essential functions that support the pharmacist role in patient care.

MUSC Health is proactively engaging in solutions to address the shortage as it exists today and to prepare for the future. We recently recruited a new system pharmacy leadership role for a pharmacy technician to provide oversight for recruitment and retention of pharmacy technicians. This position utilizes a set of criteria to ensure that we target key aspects for establishing a pipeline of technicians, engaging current techs, recruiting, and retaining with the opportunity for career ladder advancement. 

By focusing on these aspects, the role contributes to building a positive culture that enhances teamwork, job satisfaction, and overall performance within the pharmacy.

This innovative approach of a resolute pharmacy leader specifically for pharmacy technicians and supporting the role with programs across the system, has been embraced by our technicians and demonstrates the commitment of our health system to this key pharmacy role.

Thomas Maddox, MD. Vice President of Digital Products and Innovation at BJC HealthCare/Washington University School of Medicine (St. Louis): Our teams built and scaled a virtual nursing program that has demonstrated significant impact. The program provides virtual nursing services to assist our bedside nurses with their inpatient duties. The program supported 4,951 inpatient admissions, resulted in a 100% HCAHPS score for virtual nurses in the "Nurse Courtesy/Respect" domain, gave bedside nurses 1,650 hours back to other direct patient care activities, improved our admission documentation rates to >85%, and contributed to a 6.4% reduction in nurse adjusted voluntary turnover. We are continuing to scale across our entire system in 2024 and are excited to see its continued impact!

Joyal Pavey. Vice President of Advisory Group and John F. Butzer Center for Research & Innovation at Mary Free Bed Rehabilitation Hospital (Grand Rapids, Mich.): The most needle moving initiative Mary Free Bed has rolled out in the last year was created by our patient access team. The team took a stand against inappropriate insurance denials for patients needing inpatient rehabilitation and improved the sophistication of their data tracking platform to make real time decisions based on the trending data. This information is tracked by physician, by insurance plan, and by patient diagnosis. 

Using their platform, the patient access and authorization teams decide if they should complete an expedited appeal because they know for a particular diagnosis 99% of the time the insurance company will overturn the denial and allow the patient access, or if they should they go through the normal peer to peer process. They are also using their platform to track excess days patients are staying in acute care because of onerous insurance authorization processes and using that in advocacy efforts when meeting with insurance companies. Through this initiative the team has greatly improved patient access to IRF services.

Julie Oehlert, DNP, RN. Chief Experience and Brand Officer of ECU Health (Greensville, N.C.): In the past year at ECU Health we have had a laser focus on workplace safety and have added many practical innovations to signal to the communities that we serve that workplace safety is a priority for our team members and for them. We created an on-line reporting tool for our team to report workplace aggression of any kind and included a live call line if online reporting was not comfortable for them. 

We added patient behavior guidelines to our patient visit guide and emergency department journal, as well as developed visitor expectations for the safety of all. We added an assessment tool in the electronic health record so that team members would have a way to assess potential aggression in patients. We also created an online informational module for our team members that shared what we offered in their environments to keep them safe, how to report any incidents of workplace aggression, and what resources we had to support them if they were a victim of workplace aggression. We engaged EAP to ensure that all team members who experienced workplace aggression were contacted by an EAP professional for support and resources. 

We supported and fast-tracked this body of work because we acknowledge that without a safe workplace, other outcomes in quality, equity, patient and team experiences would never improve. We also love our teams and want them to have a safe environment to care for our patients and families and our patients and families want that for our teams as well!

Also, last year ECU Health supported by our Press Ganey partners began uploading our valuable and heartfelt patient comments from our medical practice patient experience surveys into several online sources. We were aware that almost 60% of consumers list online sources as their most used resource in choosing healthcare, and we wanted our patient voices to be honored through sharing them with other patients. We were also painfully aware that trust in healthcare had decreased for our patients and consumers, and that our providers post pandemic were experiencing burnout and compassion fatigue. 

By uploading patient reviews that consumers could see and appreciate, we greatly increased our provider profile reviews, and more importantly the heartfelt nature of the comments helped to establish trust through sharing real patient feedback to help consumers get to know our provider and choose a provider that was a good fit for them. The percent of patients who interacted with the profiles skyrocketed, as the experiences of our patients were shared broadly and providers saw their patient star ratings improve as we continued to upload the voice of their patients, renewing their sense of purpose and connection to those they cared for. It has been a win-win-win!

Stephen DelRossi, MSA. Interim CEO and Chief Financial Officer of Northern Inyo Healthcare District (Bishop, Calif.): In order to stabilize the district, we created a turn-around group. The committee consisted of approximately 25 permanent members, plus individuals brought in on an as-needed basis for their particular expertise. The TAG group had five subcommittees: labor (salaries, wages, benefits, professional fees); revenue; services and operations; materials, contracts, and other services; special CEO and CFO items (governmental funding, regulations, and oversight). 

Since maturation of the group, operational expenses are down more than 8%, volume is up more than 10%, and revenues are up more than 14%; we have opened cardiology, and we are in the process of opening neurosurgery (spine). We increased wages by more than 20%, reduced FTEs by more than 50%, reduced contract labor by more than 20% FTEs (+40%), and reduced wages per adjusted bed day by more than 10%. All-in-all, a good year for moving the needle.

Ramin Davidoff, MD. Executive Medical Director and Chair of the Board of Southern California (Pasadena) Permanente Medical Group; Chair of the Board and CEO of The Southeast Permanente Medical Group; Chair of the Board and CEO of Hawaii Permanente Medical Group; and Co-CEO of The Permanente Federation: With the consumerization of healthcare, patients increasingly want to be treated at home versus the hospital setting. Permanente physicians are now leading advanced medical care-at-home programs in Southern California, Northern California, Oregon, Washington and Georgia. 

Built on an integrated, collaborative team model, we have networks of skilled nurses, pharmacists, and other medical-support professionals who deliver a blend of in-person visits, telehealth services, and remote monitoring of all the comfort of a patient's home. These programs deliver high-quality care to patients with serious conditions, such as hypertension, chronic obstructive pulmonary disease, diabetes as well as acute conditions like cellulitis. With the support of technologies, supplies, and care coordination protocols, Kaiser Permanente can treat and manage patients in their home without a hospital admission. 

Data from Southern California has also shown that these patients heal faster with a reduced length of stay compared to that of a hospital stay for equivalent conditions and levels of acuity. This was expected as patients recover in the environment with which they are most familiar. At Kaiser Permanente, we are dedicated to creating innovative and transformative solutions for this new frontier of acute and subacute care delivery in the patient's home setting.

Gina Calder. President of Barnes Jewish St. Peters Hospital and Progress West Hospital (St. Peters, Mo.): In June 2023, Barnes-Jewish St. Peters Hospital became the only hospital in St. Charles County and one of only two hospitals in the St. Louis region to offer a minimally invasive, robotic-assisted lung biopsy.

The lung has no pain sensors, so cancer can grow in the lung for a prolonged period of time and spread before it invades into an area that causes bleeding or into the lining of the lung and causes pain. The delay in detection has meant that lung cancer has traditionally had one of the highest mortality rates of any cancer at time of diagnosis. By contrast, early-stage lung cancers have the best cure rate and best five-year mortality, and in many cases can be completely cured without any need for chemotherapy.

This technology has given us the ability to approach these smaller cancers – usually less than 2 cm, and in many cases less than 1 cm – and get a definitive diagnosis so we can deliver the correct treatment. It has also allowed us to mark the small cancers so we can resect less of a person's lung and retain more lung function after surgery, improving quality of life after treatment.

When compared to traditional surgical procedures, robotic-assisted bronchoscopy is non-invasive, meaning it does not require any type of surgical incision in the skin. This reduces complications and typically results in a quicker and less painful recovery for patients, many of whom can return home the same day. It also allows for other procedures to be performed simultaneously, such as biopsies and assessments of the lymph nodes, which would require additional invasiveness with other approaches.

The robotic-assisted lung biopsy is a carefully choreographed procedure that requires teamwork between physicians, pathologists, anesthesiologists, radiologists and endoscopy nurses. Being one of the first community hospitals in the region to offer the procedure helps bring our patients a level of early detection that might otherwise only be available at an academic center. Since adding the procedure, Barnes-Jewish St. Peters Hospital has performed a total of 132 robotic-assisted bronchoscopies.

Sriram Vissa, MD. Chief Medical Officer and Vice President of Medical Affairs at SSM Health DePaul Hospital (Bridgeton, Mo.): Two hospital-wide innovations have improved patient care at SSM Health DePaul Hospital in 2023. A second sign process for C. difficile testing in our EMR improved appropriateness in testing and diagnosing true infections. This intervention reduced our hospital-acquired C. Diff rates by 50% in 2023. Trained and dedicated phlebotomy team members led to a 425% decrease in our house-wide blood culture contamination rates to 1.6%, prevented inappropriate antibiotic usage, and reduced length of stay for our patients.

Maryann Alexander, PhD, RN, FAAN. Chief Officer of Nursing Regulation at National Council of State Boards of Nursing (Chicago): In keeping with its tradition of innovative regulatory leadership, 2023 was a watershed year for NCSBN with the launch of the most significant revisions to the NCLEX® Exams in its history and the publication of groundbreaking research on the nursing workforce that sparked a national conversation on the nursing shortage. 

The Next Generation NCLEX (NGN) Examination is an enhancement of the world's premier licensure exam. At the core of this enhanced exam is the NCSBN Clinical Judgment Measurement Model (NCJMM), which is a framework for the valid measurement of clinical judgment and decision making within the context of a standardized, high-stakes examination. 

NCSBN's 2022 National Nursing Workforce Survey brought into focus the crisis surrounding nursing and the intention of almost one-fifth of registered nurses to leave the profession by 2027. Addressing what can be done to stem this tide with NCSBN brought together experts from across the U.S. in an ongoing discussion on solutions to staffing, burnout and the prevention of workplace violence.

The NGN exam and the ongoing research on workforce and the discussion it generates, have significant and enduing impact on the future of the nursing profession and the health of the nation.

Amy Tucker, MD. Chief Medical Officer of Upstate University Hospital (Syracuse, N.Y.): Upstate University Hospital in Syracuse, N.Y., has successfully introduced a convenience care clinic known as the Connect Care Clinic, which has had a significantly positive impact on both patient care access and hospital throughput. Connect Care serves as a cornerstone for a variety of ambulatory initiatives, such as providing timely follow up care for patients after inpatient or emergency department discharges, implementing streamlined clinical pathways for low-acuity medical conditions, and providing onsite walk-in care. Hence, Connect Care functions as a secure bridge to primary and ambulatory care for patients from various segments of the care continuum — ED, inpatient, and outpatient. The streamlined pathway for the evaluation of patients presenting to the ED with low risk chest pain has reduced admissions for this diagnosis more than 50%.

The Connect Care Clinic also houses the Upstate Cares Program, catering to the urgent medical needs of our employees and improving the Upstate employee experience. Finally, Connect Care provides convenient access for a variety of outpatient bedside procedures, such as paracentesis, thoracentesis, lumbar puncture, punch biopsies, and PICC line placements, providing patients with access to care without the need for an emergency room or observation encounter. As part of our commitment to community service, we are expanding the clinic's walk-in clinic hours, aiming to better serve our local community.

Trevor Brand. Chief Operating Officer of City of Hope - Atlanta: At City of Hope Cancer Center Atlanta we are focused on bringing leading-edge cancer care to patients in the southeast. We have established and continued to expand a theranostics program with top-of-the-line targeted radiopharmaceuticals to treat patients whose metastatic disease is not responding to conventional therapy. Currently in Georgia we are one of five centers utilizing lutetium Lu 177 vipivotide tetraxetan to treat PSMA-positive metastatic prostate cancer patients; and one of six centers treating patients with neuroendocrine tumors in the pancreas and upper GI tract using lutetium Lu 177 dotatate. The goal with our theranostics program is to not only treat a difficult cancer, but also minimize harm to our patients' healthy tissue and provide them with a better quality of life.

Ronald Place, MD. President and CEO of Avera McKennan Hospital & University Health Center (Sioux Falls, S.D.): In May of 2023, Avera launched virtual patient monitoring to assist our bedside care teams with individuals needing intense monitoring. In the first eight months of the program, virtual monitors redirected patients more than 11,000 times resulting in a 33% reduction in falls. Additionally, patients were virtually monitored for more than 51,000 hours, equating to more than 30 full time equivalent staff hours that would have been spent providing one-on-one observations. This pioneering technology uses artificial intelligence to establish a baseline – and ultimately recoups time to focus on higher value work, leading to increased staff satisfaction while reducing falls.

Ngozi Ezike, MD. President and CEO of Sinai Chicago: In the year gone by, we successfully transitioned to Epic and launched our new state-of-the-art EMR system. It's the largest technological investment in our 104-year history. Bringing the best electronic medical record system in the industry to Sinai will dramatically improve quality, patient experience, and continuity of care across our system. We also were excited to expand our robotic surgery capabilities to further enhance the care options for our patients, adding the DaVinci robotic surgery system to our already established Senhance system capabilities. In the end, both innovations are critical components of our commitment to health equity and making sure our patients on Chicago's West and Southwest sides have access to the same high-tech options available to patients elsewhere. These are investments that allow us to give our patients and communities the care they deserve.

Alice Taku, PharmD. Pharmacy Operations Manager of Touro LCMC Health (New Orleans): Improving communication amongst team members and its positive impact on patient care.

Although improving staff communication is a Joint Commission patient safety goal, this has not often happened in the pharmaceutical workplace in a structured manner be it verbally or in the form of written handoffs.

Seeing that an opportunity for improvement existed and given the potential negative impact lack of communication could have on patient care a required process of written hand-offs from one shift charge pharmacist to another was put in place. This was an innovative process that had not existed in this setting. While an electronic hand off process was also considered it was believed team members would comply with and benefit more from a non-electronic handoff process.

This written handoff had to be documented on a form created for this purpose, placed in a binder and saved monthly for future reference if the need arose. The form comprised of a wide range of elements involving patient care issues such as critical infusions, unusual therapies patients were on, medication outages-burrowed, loaned out- staffing challenges including call ins, tardies, early departures, technological issues involving our automated device system (Omnicell) including Omnicell cabinet break down, Omnicell fill, delivery etc.

Since the implementation of the mandatory required written hand off about 18 months ago pertinent patient information as well as other ancillary information has routinely been passed off from the outgoing team of pharmacists to the incoming one on all three shifts leading to improved collaboration between team members as well as improved pharmaceutical care provision to our patients.

Michael Bublewicz, MD. Vice President and Chief Medical Officer of Emergency and Urgent Care Services at Memorial Hermann Health System (Houston): Implementing an ambient listening AI-powered documentation tool for the physician enterprise has been a significant achievement in the past year. This initiative was born out of our dedication to addressing a key challenge faced by our physicians - the time-consuming nature of documentation. Using artificial intelligence and ambient listening technologies, we are optimizing the documentation process, enabling our physicians to dedicate more time to patient care. Early data highlights notable time savings, increased efficiency, and enhanced satisfaction among our physicians. This tool empowers our medical staff to deliver high-quality care more efficiently, underscoring its transformative potential within our healthcare system. 

Jill Hoggard Green, PhD, RN. President and CEO of The Queen's Health System (Honolulu): The Queen's Health System recently opened a new command center designed to improve patient access, care coordination and quality of care.

Aptly named The Aukahi Center — which figuratively means smooth and flowing together, united — this new command center provides real-time visibility to supply and demand for inpatient capacity — at a system, facility and unit level. With support from GE HealthCare's Command Center software program, care teams can view near-term bed capacity and route patients to the best site of care, improving patient throughput and the transfer process while increasing access to care.

This is the first major project completed by the Queen's Innovation Institute, which launched in March 2023 and is the first of its kind in Hawaii. 

The Innovation Institute's goal is to use technology to improve access to care — from emergency care to elective appointments and from admissions without long boarding times to timely discharges and transfers. The Innovation Institute's command center will bolster QHS' efforts to increase access to high quality care by improving continuity and collaboration among the various teams and departments that provide care during a patient's hospital stay.

Pradeep Kadambi, MD. President and CEO at University of Florida Jacksonville Physicians; Senior Associate Dean for Clinical Affairs at UF College of Medicine – Jacksonville: Addressing leakage of radiology studies: This was a multiyear process, and the pandemic did not slow our strategy. In 2018, our radiology leakage rate was 23%. Our study revealed that the patients and payers were demanding convenience and lower cost options for imaging. In collaboration with the department of radiology, at the beginning of 2020, we started two full service free standing imaging facilities in strategic parts of the town. We educated patients, payers and our practices of the new service options, and continued to monitor the leakage rate.

In December 2022, our imaging leakage rate was <10%, and in December 2023, or leakage rate was <2%. Now, we are in the process of converting our freestanding imaging centers into independent diagnostic testing facilities.

Nwando Anyaoku, MD. Division Chief Health Equity Officer of Providence (Renton, Wash.): I am incredibly proud of the Providence Health Equity Fellowship program, an initiative we recently launched that empowers caregivers to design specific equity programs to meet unique needs of their patient populations. Last year, our inaugural cohort of 19 caregivers dedicated 25% of their time to the program, receiving didactic training on health equity, process improvement and leadership development. Today, each has launched their respective initiative, and we are thrilled about the results we are seeing in this short time. From advancing language access and health literacy for patients with limited English proficiency to expanding data collection to improve care needs for our LGBTQIA+ populations, we are moving the needle on shortening health equity gaps that have plagued our communities for decades. I am excited to see how far we will go in 2024.

Phillip Chang, MD. Senior Vice President and Chief Medical and Quality Officer of Memorial Hermann Health System (Houston): At Memorial Hermann Health System, we continue our high reliability journey with the development of a system balanced scorecard that unifies the organizational effort on key benchmarked quality measures. With the alignment of quality goals and incentive structures, we are already seeing promising early results.  

In addition, we strengthened the connection between our system risk and patient safety committee and high reliability council. As process gaps are identified and learnings are shared across the system, we then deploy analytics experts and process improvement blackbelts to implement changes with the full support of medical and nursing staff, as well as operational leaders. 

Finally, we have a close working relationship with our strategy and innovation partners to highlight quality and safety to be foundational in everything we do; and began deployment of AI to enhance our work.

Cyril Philip. Vice President of Digital Ventures of Bon Secours Mercy Health (Cincinnati): Bon Secours Mercy Health is harnessing the transformative power of Conversational AI to help patients navigate the healthcare system. In October 2023, we launched Catherine™, a personal, digital healthcare assistant. Named after Catherine MacAuley, who founded the Sisters of Mercy in Dublin in 1831, this platform was created to bring their vision and proactive outreach to the modern era. In her initial pilot, Bon Secours Mercy Health chose to focus Catherine’s abilities on the dementia journey, providing support and aid to caregivers navigating this incurable illness. We are exploring expanding Catherine across additional health journeys in 2024, including MSK, cardiovascular, and health benefits navigation. 

James Forrester. Chief Transformation Officer and Chief Information Officer of University of Rochester Medical Center (N.Y.): The most needle moving innovation that we have rolled out at URMC in the past year is ambient digital scribe technology. We started with a small pilot in our orthopedics department that has proven successful. The technology makes a notable difference for providers both from provider satisfaction and productivity perspectives. The patient experience is enhanced by increasing the amount of time providers spend interacting with the patients. Our plans are to move into a broader pilot in other ambulatory settings with an expectation that this technology will advance and mature to support other members of the care team including nursing. We also expect the setting to expand beyond ambulatory medicine to include  uses such as  triage and patient discharge.

Whitney Haggerson. Vice President of Health Equity and Medicaid of Providence (Renton, Wash.): Inpatient SDOH screening standardization: Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health. In our efforts to advance equity for our patients, it is imperative that we meet patients' unique needs, including understanding and addressing social determinants such as housing, food insecurity, transportation, utilities, and financial resource strain. 

In alignment with new regulations from CMS and The Joint Commission, in 2023 we worked to increase screening rates across 52 acute care hospitals by creating a tool in Epic to screen patients for housing, food insecurity, transportation, utilities, and financial resource strain. While documenting these factors is flagged as required, as we designed the tool, we were able to eliminate other unnecessary and/or duplicative documentation for our clinical caregivers, streamlining and simplifying the process significantly.

This tool went live mid-September 2023. In August 2023, screening rates across our facilities were less than 2% for housing, food insecurity, transportation, and utilities and 44% for financial resource strain. By December 2023, Providence screened 87% of all inpatients for each of these domains, resulting in an 85% improvement for housing, food insecurity, transportation, and utilities and a 43% improvement for financial resource strain. The improvement in SDOH screening rates was realized in under 4 months!

Alina Moran. President of Dignity Health, California Hospital Medical Center (Los Angeles): California Hospital Medical Center has collaborated with a network of federally qualified health centers to offer Samaritan memberships to unhoused patients. Samaritan, a support platform, extends direct financial and social assistance to individuals, aiding them in achieving housing and life goals. Since its inception in May 2022, the Samaritan program has positively impacted 200 vulnerable patients, demonstrating significant success. We have also seen a significant reduction in inpatient costs and a substantial decrease in emergency department utilization.