Some 'reinvention' opportunities from pandemic are here to stay, COO says

The COVID-19 pandemic brought on a tidal wave of challenges across all healthcare systems. And cancer hospitals and oncology departments had to manage not only those rapidly increasing concerns but also the critical timeliness associated with managing cancer patients. 

"At the start of the pandemic, our necessary focus was to care for COVID-19 patients through times of rapidly changing care needs, high patient volumes, a shortage of medical literature to guide care and supply chain complexity," Mark Davis, MD, COO of Miami Cancer Institute and Baptist Health Cancer Care in Miami, told Becker's. "It was essential that while we worked to attend to COVID patients, we simultaneously screened and diagnosed patients with cancer as early in their cancer journey as possible."

But the challenges did not stop there. Dr. Davis said even as his team treated patients with COVID-19 and diagnosed and developed treatment plans for cancer patients, everyone was also focused on how to retain and attract new healthcare employees to help manage patient overload. 

He said many initiatives started during the pandemic will be kept in place at Miami Cancer Institute and Baptist Health Cancer Care because he believes they "reinforced the need to be nimble with resources and to deploy them in different ways than originally intended."

As examples, he said cancer nurses became patient screeners, physicians monitored front-line workers for appropriate wearing of personal protective equipment to protect workers and hospitals from different systems were able to share resources and knowledge. 

"As a result, we are now better able to quickly pivot and act, in the face of a challenge," Dr. Davis said. "This taught us that we can do so much more than we previously thought possible."

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

Question: What is the biggest initiative you implemented to right the ship during COVID that you are planning to keep in place?

Dr. Mark Davis: Certainly there were many challenges during COVID-19 and, consequently, many opportunities for reinvention. The biggest initiative was taking a more disciplined approach to achieving both mission and margin objectives by being strategic with focus and being willing to pivot when data and people suggested a change was needed. This meant monitoring metrics for key patient-centered objectives, as well as cost management and maximizing margin opportunities. 

Healthcare needs to be sustainable and financially viable; we must attend to that. But as healthcare leaders, we must also be crystal clear in our commitment to serving patients and our communities. With a disciplined approach to achieving both mission and margin objectives, we can balance both needs and modify our approach as needed. The capacity to be flexible and also disciplined is what leads to long-term success.

Q: What hospital business issue keeps you up at night?

MD: Uncertainty surrounding reimbursement for mission-critical activities is an issue of great importance to us and the healthcare system in general. Like the stock market, uncertainty is a challenge for long-term success, and it makes planning and delivery of highest quality and value care in healthcare difficult.

To counter this uncertainty, the healthcare industry has the important opportunity to continue evolving toward a more disciplined approach in managing and adapting its "business." This includes consistently integrating standard change management procedures, expense management and revenue generation, all while focusing on "true north": our cancer patients. 

Q: What is the biggest challenge you plan to tackle this year at your hospital?

MD: The only way to truly deliver a consistent and world-class, patient-centered culture is by also having a strong organizational culture. Therefore, we will work on further strengthening employee engagement. 

It is crucial that all team members — from the front-line employee who just joined to the doctor who has been running a surgical department for years — feel included and heard. Leadership must recognize team members' voices have incredible value as well as the potential to effect positive change. Further engaging our great employees in a structured and consistent way to adapt and iterate as the healthcare environment continues to change is critical to reach mission and margin objectives. It is also the right thing to do.

Q: What is something your colleagues can do right now to manage their burnout?

MD: Burnout in healthcare is a serious issue, with highly respected entities such as the office of the surgeon general, the Association of American Colleges and the National Academies of Engineering, Science and Medicine raising the alarm regarding this issue along with provider shortages in the past couple of years.

As with most serious issues, there is no single, perfect solution, but there are important actions we can take.

A well-run clinical environment requires using a multidisciplinary team approach where a disciplined structure with clear goals/objectives/metrics coexist with each employee knowing  their opinions are heard and respected. It is possible to create a structure for empowering diverse voices to speak and for our team members to know that they hold many answers and have the ability to effect change.

Communication is critical. This includes presenting information in a transparent fashion in regular "town hall" meetings so that leaders and all employees can not only understand current circumstances in place of assumptions that may be incorrect, but also grapple with the challenges as an interconnected team. Having transparent conversations often, and with true curiosity and gratitude, allows all members to respond with helpful new approaches not previously considered.   

Q: What is a lesson you wished you learned sooner?

MD: We must keep an open mind and bring in lessons from industries outside of healthcare, including lessons around strategy, operational advancements, utilization of metrics with authority/responsibility and business discipline. These should be a part of early training for hospital leaders and folded into hospitals' best practices. 

While it is true that healthcare has many unique attributes — most importantly that we are dealing with life and death issues — there are many lessons learned from other industries that are applicable. Successful approaches exist in many industries and we can borrow from these versus re-creating our own for healthcare. We need to be open and curious enough to reimagine what we are able to do with what already exists — and then do that efficiently, with discipline and awareness.

Q: What is going to be the next trend in healthcare and why?

MD: I foresee three main trends in healthcare.

One, as cost pressures mount and a rapid application of technologies in healthcare to leverage resources takes place, we will almost certainly see a continued trend toward outpatient therapy and at-home care with telehealth support.

Two, we will see a continued focus on value- and outcomes-based measures, given the lack of long-term sustainability of our cost structures and need to improve results and value. 

Three, it is wonderful to see the increased frequency of individuals advocating for their health and that will continue to grow. I have been interested in patient engagement and medical decision-making throughout my career. We work in service of our patients and communities.  Being a patient-centered provider requires empowering patients, expanding access to communities that have had less engagement in the past, facilitating patient involvement and ensuring their satisfaction as we engage all stakeholders in the healthcare journey. 

Our patients have greater access than ever before to research, treatment alternatives and outcomes achieved. We must thoughtfully continue down that path and embrace this trend to advance patients' care and the efficacy of our healthcare efforts.

My expectation is that with these trends and advancements, we will advance our focus on prevention and keeping individuals healthy. Health promotion is the most patient-centric and cost-effective intervention.


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