Cedars-Sinai's COO: Leading staff from 'traumatized' to a post-pandemic comeback

Jeffrey Smith, MD, executive vice president of hospital operations and COO for Cedars-Sinai Medical Center in Los Angeles, is placing the wellness of his staff and physicians at the top of his 2022 agenda. "We're all kind of traumatized," he told Becker's in January. But the Southern California health system is far from slowing down. Dr. Smith discussed plans for the new Cedars-Sinai Guerin Children's Center and the organization's continued focus on the maternal-fetal mortality crisis affecting minorities. 

Note: This interview was lightly edited for length and clarity.

Question: Cedars just received a philanthropic gift for a new children's healthcare center. Can you talk a little bit about this new center, the inspiration behind it and what you hope to accomplish with it? 

Dr. Jeffrey Smith: We're very pleased and excited about this generous gift from the Guerin Foundation, which is really enabling us to take this journey. We have done quite a bit in pediatrics here at Cedars-Sinai. We have a very large maternal-fetal medicine program. We deliver approximately 6,000 babies every year. We have a large neonatal intensive care unit, and we have some other pediatric specialty programs as well, and we're really looking to build on that strong base of children's health that we have already and expand it. We are known for our high quality adult specialty programs, like cardiology and cancer surgery and others, and we hope to also extend those programs to children as well.

Q: There has been a lot of discussion about mental healthcare, especially among children and adolescents. Will the new center have a mental healthcare component?

JS: While we are continuing to build out the final plans for this, we do anticipate that it will be a comprehensive program and include mental health, but likely not inpatient. We don't currently do adult inpatient psychiatric care, but certainly there will be behavioral and mental health components to the program.

Q: What are your top three goals and priorities for 2022?

JS: Obviously we're continuing to look forward to the next stage of the COVID pandemic and recovering from that, and a lot of that recovery is going to be focused on our employees and our physicians' wellness. We're all kind of traumatized from the past several years that we've been dealing with this pandemic, and we do have burnout as well as stress and anxiety and other fallout from the pandemic experience that we've had.

There's also going to be a lot of focus on recruiting and workforce planning. We have very dedicated and loyal employees who are highly engaged, but we need to continue to attract the best and continue to rebuild after the pandemic. So there will be a significant focus on recruitment and retention as well.

There's also our work in health equity, which is another area where we've had lots of work going on, but it really wasn't well coordinated or brought under a single umbrella. Almost three years ago, we appointed our first chief health equity officer and created the department of health equity, and that really has served as an organizing body that's gathered and helped to accelerate our efforts in health equity. This includes doing research as well as education, including unconscious bias training for all of our staff as well as specific programs to address issues in health equity. 

One of these programs is focused on reducing the rate of maternal and fetal deaths in minority populations. This has actually been a focus of ours for a number of years now, and we have partnered with other organizations, including the state hospital association, to help address this issue. Despite the progress that we've made in reducing maternal-fetal mortality, there's always been a discrepancy between whites and non-whites. It's occurring primarily in Hispanic, Latinx, and Black communities. We've been focusing on understanding what those issues are, and as you'd expect it's really multifactorial. Certainly there are healthcare access issues and issues around socioeconomic status, and what we're finding is that those things can combine, and the chronic stress that these communities are under can affect outcomes as well. It's really about doing the research to help understand why that disparity continues to exist, and then putting programs in place to help address it –– making sure that they have good prenatal care and follow up, and then we're helping to address some of those higher risk issues that might arise.

Q: What skills do you think are essential for hospital and health system COOs to have in order to thrive in today's healthcare landscape?

JS: I think this has always been true, but now more than ever, we need to listen to our people. Spending time on the front lines, understanding how our staff is being impacted, specifically because things are changing so quickly. Listening to our people and understanding their needs is probably number one. I think number two is the need for communication because, once again, things are changing so quickly and we need to be creative and look at different forms for that communication. For example, we've been holding virtual town halls several times a week for our leaders and our frontline staff. We need to be open and transparent by telling people what we know and what we don't know, and we need to be providing them with the information they need to do their jobs. I think the third thing is being able to look at data and make data-based decisions, but be able to do that very quickly. We need to make sure that we have the information that we need to make the best decision at the time, and remain agile as we adapt to a rapidly changing environment.

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