TDP 110: BJC HealthCare's System CMO, Dr. Bruce Hall: The Evolution of Healthcare Quality, Transforming Medicine With Data, and Strategies to Improve Frontline Buy-In for Quality

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On this episode of "The Digital Patient" podcast, hosts Alan Sardana & Dr. Joshua Liu speak with Dr. Bruce Lee Hall, Vice President and System Chief Medical Officer at BJC HealthCare, about "The Evolution of Healthcare Quality, Transforming Medicine With Data, Strategies to Improve Frontline Buy-In for Quality, and more..." Click the play button to listen or read the show notes below.
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Audio:

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Video:

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Guest(s):

• Dr. Bruce Lee Hall, Vice President and System Chief Medical Officer at BJC HealthCare
• Dr. Joshua Liu (@joshuapliu), Co-founder & CEO at SeamlessMD

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‍Episode 110 - Show Notes:

[00:01:26] Why Dr. Hall got into healthcare through his motivation to combine his scientific interests with a service mentality displayed in his family members;

[00:02:53] Why Dr. Hall was drawn to the analytic aspect of measuring quality in medicine and surgery and how it led to the realization that there are many attached philosophical questions to measuring quality;

[00:04:30] Why Dr. Hall adopts a "working foreman" mentality to get frontline staff to care about quality, where leaders have to be vulnerable, lead by example, care about each patient, and prove they will bring resources to make patients' lives better and make it easier for staff to do the right thing;

[00:06:09] Why Dr. Hall explains getting an MBA was a critical experience for him as he gained exposure to policy, strategic thinking, operational thinking, and finance — in particular insurance theory — yet, how it may not be necessary for everyone as he advises individuals to think about what they want to accomplish and what skill sets they want to gain before deciding to pursue an MBA;

[00:08:21] How Dr. Hall decided to move into administration and leadership, as a way to increase the impact of his work on measuring quality and changing the world in front of him, and why he recommends others who want to pursue such a path to find a problem they can contribute to and volunteer to help, rather than waiting for an invitation;

[00:11:36] Dr. Hall reflects on the impact that NSQIP and quality initiatives have had on the cultural transformation of surgery, with surgeons now expecting to be measured and focused on improving in response to patient expectations

[00:13:35] Why Dr. Hall believes NSQIP will continue to adapt to the changing landscape of data and analytics, becoming more granular, real-time, comprehensive, and less overwhelming to users

[00:16:26] Why Dr. Hall emphasizes the importance of challenging clinicians to think the same for operational excellence — knowing it is counterintuitive;

[00:20:10] Why Dr. Hall describes value-based care as an effort to correct the fractures and fragmentation in the healthcare system, and highlights the goal of reconnecting decision rights, high-quality information, and resource availability;

[00:21:19] Why Dr. Hall believes the future of healthcare delivery lies in increasingly adopting value-based care, despite the higher financial risk for provider organizations and the need to realign various aspects of healthcare delivery;

[00:23:11] How COVID disrupted quality improvement efforts over the last couple of years, how the bandwidth for focusing on quality and safety has not fully returned due to ongoing financial stresses in health systems, yet why the healthcare system needs to move towards more sustainable models and not kick the can down the road, despite the ongoing financial challenges;

[00:25:31] How the entry of big tech like Amazon and Google in healthcare is creating new pressures on health systems to rethink what needs to happen inside the hospital walls and how to be a growth partner for the community;

[00:30:00] How one effective strategy for increasing communication channels between leadership and frontline staff is regularity of communication — hosting an “office hours” session. Dr. Hall emphasizes the importance of establishing consistent communication sessions that give people the opportunity to ask questions or receive information.

[00:30:22] Why Dr. Hall advocates for huddle structures that escalate up and down the organization as it can be a key strategy for communication, allowing the frontline staff to escalate information to the next huddle and ultimately to leadership;

[00:32:20] Why Dr. Hall emphasizes the importance of finding the right balance in communication, ensuring that people feel heard without being overwhelmed as over-communication can lead to fatigue and diminishing returns;

[00:33:19] Why Dr. Hall is passionate about patient-facing innovations that increase convenience for patients and families, such as online electronic communication that empower the patient to provide feedback on provider performance, as this direct patient feedback can have a significant impact on quality and safety in healthcare;