8 hospital COOs on their most pressing issues

Hospital and health system COOs are focused on issues ranging from boosting employee engagement to reducing length of stay and readmissions, they told Becker's.

Below are COOs' top priorities for the rest of 2022, in their own words. Their responses are below, in alphabetical order. 

Editor's note: Responses were lightly edited for clarity and length.

Erin Asprec. Executive Vice President and COO of Memorial Hermann Health System (Houston): First, we want to ensure a phenomenal employee experience by focusing on the resiliency and engagement of our employees and doing all we can to support recruitment and retention. Second, we want to ensure an excellent patient and consumer experience by reinforcing our service commitment and standards, and improving our digital interactions. Memorial Hermann will maintain its focus on delivering high-reliability care while redesigning our clinical and operational processes to improve the way we care for patients and decrease costs. These will set the foundation for the coming years. Finally, we want to continue meeting the needs of our community, and that means growing with an ever-expanding Greater Houston and expanding our portfolio of services.

The healthcare and business industries are constantly changing. We must continue to adapt seamlessly to these changes as we embrace new advancements and innovation. To that end, we're working tirelessly to evolve our models so we can deliver greater value and more innovative care, putting the patient at the center of everything we do. It's how we plan to achieve our vision of creating healthier communities, now and for generations to come. 

Tiffany Caster. COO of Dignity Health Saint Francis Memorial Hospital and St. Mary's Medical Center (San Francisco): To say that the past two years have been transformative for the healthcare industry would be an understatement. I continue to be inspired by those who, despite being physically and emotionally exhausted, selflessly answer their calling to serve with a commitment to our communities and to each other. As a healthcare industry, we have learned many lessons throughout the changing course of the pandemic, including developing alternative and virtual care settings, agility with staffing of clinical positions and greater resilience in supply chain management, to name a few. As we look ahead at the rest of this year, here are some of our priorities:

Quality: Challenging the status quo and continuously improving to bring world-class services to our patients.

Employee engagement: Creating forums for meaningful conversations, so we can support our team members as they experience everything happening in the world and in healthcare. Caring for our staff so they can be present and connected with our patients. Creating opportunities for staff to own and test their improvement ideas. 

Growth: Meeting the unmet needs of patients by expanding services offered by our Burn Center, Gender Institute, and our orthopedic and spine programs.

Affordability: Providing care that is sustainable, delivers more value and remains financially accessible to the communities we serve.

Integration: Delivering best-in-class care and value for our patients by aligning multiple hospitals through shared best practices, mitigating redundant resources and fostering a collaborative environment.

Emily Combs, MSN, BSN. COO of Mercy Hospital St. Louis: At Mercy, we're focused on providing care that is personalized, predictive and proactive. To do this, we're tapping artificial intelligence for data to give our patients care tailored specially for them. This information will help us reach out to someone to ensure they get the care they need before a health problem arises.

Length of stay is another high priority area at Mercy because we know it's best for our patients to reduce days in the hospital and return home as soon as possible to recover with the support of family and friends. It also helps with co-worker shortages, one of the sharpest pain points for healthcare systems across the U.S.

A few other bigger picture priorities include workforce transformation, increasing the number of people we serve, especially post-COVID when many have not received the care and screenings they need, and making it easier for patients to access care in more convenient locations as quickly as possible.

Patrick Falvey, PhD. COO of Baptist Health (Louisville, Ky.): Priorities for the balance of 2022 — and likely beyond — are staffing and managing costs. Staffing is a challenge on many levels, from filling vacancies due to retirements and other turnover, to hiring for newly created positions due to growth, and retaining current staff wearied by more than two years of battling COVID. We are also looking ahead on staffing, partnering with nursing schools and residency programs to invest in medical education and recruit some of the region's top talent to care for our patients.

The costs of staffing are among the largest expenditures for healthcare systems today, along with supplies and equipment. Inflation and supply chain challenges put a crimp in hospital budgets. With these financial pressures, we must manage these costs along with seeking higher reimbursement from payers.

Angie Hammons, MSN, RN. Vice President and Chief Nursing Officer/COO of Dignity Health Methodist Hospital of Sacramento (Calif.): The changing environment of healthcare has been significantly impacted by the COVID-19 pandemic. Burnout and fatigue have significantly impacted our clinicians, and retaining and recruiting clinical staff has been increasingly challenging. Additionally, hospitals were burdened by the financial impact of hiring temporary support and delays in elective procedures.

As the chief operating officer, my priorities for the rest of the year include: continued culture work to improve quality and safety by ensuring high-reliability practices are hardwired and universal skills are integrated into our daily work. Some examples of this would be integrating employee recognition practices, solidifying safety huddles, utilizing safety coaches, and expanding multi-professional partnership councils at the department level for problem-solving issues and adjusting processes to improve efficiencies. Another priority focus for the coming year is to ensure the quality, safety and experience of our patients are highly reliable by focusing on patient-centered care and the reduction of unjustified clinical variation. Of course, recruiting and retaining talent and improving the employee experience are becoming more important than ever. Clinicians have options and will select organizations whose values are aligned with their own. Focusing on this will improve efficiencies by reducing costly turnover and will subsequently improve productivity and financial performance.

Doug Hock. Executive Vice President and COO of Children's Hospital of Philadelphia: Those of us working in healthcare today face many concurrent challenges as we seek to fill open positions, accommodate significant inflationary pressures and support our employees — all while continuing to provide the best care possible for our patients. At Children's Hospital of Philadelphia, we are making a concerted effort to increase efficiencies across the enterprise, with a focus on simplification, standardization and elimination of non-value-added work. These efforts range from the large-scale transformations of our electronic health record and revenue cycle processes to more grassroots programs, such as "Getting Rid of Senseless Stuff," an employee-led initiative that generates ideas for eliminating bureaucracy and red tape to streamline work processes. We're confident that these efforts will help us better manage our expenses while at the same time ensuring a better employee and patient experience.

Rob Maloney Jr. Executive Vice President and COO of Erlanger Health System (Chattanooga, Tenn.): As we enter the last four months of 2022, there are three priorities I am focusing on; engagement, quality and patient experience. All three aspects impact each other as well as Erlanger's mission, "We compassionately care for people." I want to engage Erlanger's associates in quality, meaningful ways to support them while also encouraging them in the pursuit of their calling to care for those who can't help themselves while recognizing their many obstacles including burnout and staffing issues. Additionally, over the last two and a half years COVID has consumed the majority of our energy while other quality initiatives quietly worked in the background. Now, I am refocusing my attention to reengage the teams and continue to improve in important quality measures such as sepsis, catheter-associated urinary tract infections, central line bloodstream infections and other important measures.

Finally, but most importantly, patient experience. Engagement and quality both feed into the overall patient experience. With less staff, lower margins and little room to endlessly invest in every department, the question remains, "How do we improve the human experience?" As we continue to add to our caregiver and provided responsibilities, how do we engage staff to spot the inertia of a busy day to stop and listen, hold a dying patient's hand or go above and beyond to improve the personal experience of healthcare.

Faraaz Yousuf. Executive Vice President and COO of WellSpan Health (York, Pa.): As we emerge from our most recent pandemic surge and look to a healthcare environment where COVID-19 has become a part of our daily work, we continue to face challenges in a few key areas that have defined the industry throughout the pandemic. Namely, staffing resources, supply chain disruption and patient access have been areas of strategic focus.  We continue to work toward staffing levels that we were accustomed to pre-pandemic, and supply chain disruptions have shifted from [personal protective equipment] to more elaborate clinical disruptions such as CT contrast shortages or numerous pharmaceuticals. Our focus at WellSpan is using a Lean standard work to address staffing challenges while using our sophisticated service line-based approaches to nimbly respond to supply chain disruptions. We also continue to concentrate on improving our patient access and shift toward meeting patients where they want to be seen in the ambulatory space. To accomplish this, we are leaning into our throughput initiatives to drive access in our acute settings.


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