The most effective leaders have realized staffing issues and shortages aren't going away, but there are plenty of opportunities to redesign healthcare delivery for even better patient outcomes and experiences.
Richard Isaacs, MD, CEO and executive director of The Permanente Medical Group, president and CEO of the Mid-Atlantic Permanente Medical Group and co-CEO of The Permanente Federation, joined the "Becker's Healthcare Podcast: to talk about healthcare transformation in the wake of the COVID-19 pandemic and workforce shortages.
The interview below is edited lightly for clarity.
Question: What are you most excited about?
Dr. Richard Isaacs: I'm most excited about the incredible opportunities that have presented themselves to transform the way we deliver healthcare. When you look at every major disruption over the last hundred years in healthcare, there's been some external force that has driven change, and we're in one of those opportunities right now. Thirty-six months of the pandemic with all of those surges that we had really unveiled tremendous challenges, but also opportunities.
I see this as a great moment in time to really transform the way we look at healthcare. We have an opportunity to bring in technology and really leverage it in meaningful ways to drive efficiency, have the right expert at the right time throughout the system, and just drive tremendous operational excellence using technology and leveraging the exceptional staff that we have.
Q: What are the issues you're spending most of your time on right now?
RI: We are coming out of the pandemic with incredible demand for care. Some of that is related to the care delays that existed during COVID. Our hospitals are, frankly, really full right now because patients did not get the care they needed. During the past 36 months, we're seeing more advanced breast cancers presenting, we're seeing more advanced colorectal cancer, and it's just our emergency departments are filled with patients that have more severe illness than we saw before.
We have higher volumes of severe illness than we saw before, and that to me is an impetus for change. We need to figure out how to best use our capital and human assets to drive the highest performance, highest quality with industry leading operational excellence throughout the program.
Q: I would love to hear your thoughts on what the most effective healthcare leaders need right now to be successful in the next two to three years.
RI: The most effective leaders are going to need clarity of vision and clear communication to all the people doing the work. It's going to be really important that we empower those leaders and physicians and frontline workers that are closest to the work as we're looking for innovations for change. That goes back to the opportunities that we have right now. We have to leverage this crisis to really come back out on the back end with incredible transformation.
Q: Absolutely, and I'd love to touch on staffing issues as well. What is the top issue you're experiencing related to staffing and how are you approaching it?
RI: The most important aspect of staffing is making sure the demand for care has a supply of resources to meet the demand. When I think about the care delivery from the past, we were able to match resources by bringing in more people, hiring more nurses, driving more expenses. We're in a new world now where expense inflation is not going to be possible. It's going to really be about thinking differently about the way we provide care.
If you have an emergency department that has a waiting room filled with patients, we've got to think differently about how we care for those patients. In our medical centers, we've moved physicians to the most forward area of the ER and created a physician triage, I call it physician in treatment process, where the right expert at the right time is managing triage and treatment of those patients, which creates more capacity by removing the lower acuity patients in the most effective way to create the resources in the more high acuity areas of the emergency department to take care of those patients. That's one way to change the way we think about care, to decrease the demand on resources.
There's a tremendous opportunity to leverage technology as well to help eliminate redundancies in care without delay. Having the right subspecialist available immediately when the patient needs it in the emergency room or in the hospital can decrease the length of stay and ultimately create more capacity.