← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
David Rahija, PT, MBA, FACHE, President of Northwest Community Hospital at Endeavor Health
00:18:46
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- [00:02]
A
The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit and more, the conversations get real. Leaders will share how their scenario planning for policy shifts brief breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
- [00:46]
B
Hello everyone and welcome to the Beckers Healthcare Podcast. I'm Mackenzie Bean, Associate Vice President and Managing Editor of Becker's Hospital Review. Today I am so thrilled to be joined by Dave Rajia who is the President of Endeavor Health Northwest Community Hospital. Hi Dave, thanks for joining the podcast. How are you doing today?
- [01:08]
C
Doing well Mackenzie, thanks for having me on.
- [01:10]
B
Appreciate it, of course. I mean it's a pleasure to have you back. I know you've been on the podcast before. For any listeners who might be hearing you for the first time, I was hoping you could just tell us a little bit more about yourself, your career and then of course, Northwest Community Hospital.
- [01:26]
C
Yeah. Thanks Mackenzie. Dave Rahia I've been part of Endeavor health now for 17 years. Just as an overview, Endeavor Health is a health system in the Chicago suburbs in Chicagoland including Chicago. Consisting of nine hospitals, over 300ambulatory sites of care. We take care of almost 1.4 million patients a year with our incredible team of 27,000 team members. Endeavor Health is relatively a newer health system by name. It is actually coming together for successful health systems over the last five years. North Shore University Health Systems and Health System in the northern suburbs of Chicago, Swedish Hospital in the north part of the city, Northwest Community Hospital in the northwest suburbs of Chicago and Edward Elmhurst Health which is in the western suburbs of Chicago. We came together really like minded non for profit community based health system dedicated to excellence and serving our communities and it's been a great ride. As I mentioned, I've been part of the health system for 17 years starting at Glenberg Hospital, started our orthopedic and spine specialty hospital in Skokie, President of Operations of the Endeavor Medical Group as we brought together the four employed medical groups and I have now the privilege and pleasure almost a year now serving at Northwest Community Hospital which is our biggest of our nine hospitals licensed for 500 beds, multiple off sites and it's really been A pleasure and like I said, privilege of serving this community.
- [03:20]
B
Absolutely. And as you said, you're almost a year into your new president role. As you reflect back on the last 12 months, what would you say is the most important initiative that you've led? Can you tell us more about it and what sort of results have you seen so far?
- [03:37]
C
Sure, yeah. Mackenzie, as I think about where we are in the evolution of our health system, we really are challenging ourselves as, as a health system to come together and not just be a collection of hospitals or collection of provider practices like most health systems across the country, but really challenging ourselves to be a truly integrated system of care across the continuum of care. Northwest community obviously is a big part of that, just given its size. Each of the hospital presidents within Endeavor also are executives over clinical clinical service lines for all of Endeavor, working with our physician or singular physician executives for each service line. Mine are surgical services across all of Endeavor, Neurosciences and rehab. To answer your question, mackenzie really working on bringing together, integrating and creating consistent and seamless seamless care service lines across all of Endeavor across all of Chicagoland. I would say that is a lot of work. It takes a lot of bringing stakeholders together, but really challenging everyone to put your best practices on the table. Let's do best practice research. But at the end of the day, how do we reduce unnecessary clinical variation and really settle on a singular Endeavor health way best practice across all of our service lines? And so that has been a lot of the work that we've been doing this past year. And I would say with, with very good success. It's been really gratifying to see all of our clinical experts, our leaders, our team members coming together, really focused with the patient in the center on designing what does seamless care, safe, seamless and personal care look like across the entire continuum of care from the office to the hospital, to post acute, if necessary, back to the office. And how do we do that in a seamless fashion? It's a big body of work, but it potentially is going to really differentiate us in the Chicago market.
- [05:52]
B
Yeah, no small tasks like you said, but so crucial to really achieve, like you said, that true integration, especially across those specialties that you're overseeing. I'm curious, how are you going to carry this work ahead in 2026? What's coming down the pipeline? As you also think about some of the headwinds that health systems nationwide are facing right now?
- [06:16]
C
Sure, yeah. I think to that end, relative to integration, our single biggest project within Endeavor is taking three instances of EPIC and go into a singular instance of EPIC for all of Endeavor Health, all nine hospitals, all of our off sites, our entire enterprise working off a singular platform. That is really going to be an enabling, a significant enabling step to really allow us to really take our integration and differentiation to the next level. And as you can imagine, anyone who's gone through an EMR conversion, this is a major, major project, but one that the investment of time, resources and energy should produce significant results. To your question, Mackenzie, relative to headwinds, obviously the US Healthcare industry is going through a very tumultuous period, especially relative to financing. Just like the rest of the country, we are preparing for patients in our communities losing coverage, whether that is through Medicaid, whether that is not having access or ability to buy plans on the Affordable Care act exchanges or other means. We are committed to our communities as a not for profit health system. So really working with our partners, working as a system and using all of our assets to ensure that we continue to serve and take care of everyone in our community, but at the same time continue to differentiate and grow, that is going to require very much a system approach and making probably difficult but necessary decisions to ensure that we not only survive this period, but continue to thrive.
- [08:15]
B
We know so many systems are focused especially on access right now, acknowledging a lot of those, you know, federal headwinds as well. And you know, I think that goes hand in hand with thinking through strategic integration. So I'm curious to like hear from you and your perspective specifically honing in on know you said your work in surgical services where we're also seeing, you know, heightened demand for inpatient care and surgical demands as well. How are you thinking about that specifically?
- [08:46]
C
Yeah, there's no doubt as more and more surgical procedures are moved off the inpatient only list, we're going to see, especially from our physicians that are aligned with us through independent practice, potentially pull cases to ambulatory surgery centers where they are aligned. We are looking at our surgical platform to ensure that our cost structure is ready for site neutrality and reducing our cost structure with the assumption that we're just going to get paid less for the work that we do. So to continue to deliver the high quality care, invest in technology, but utilize it where the evidence shows that it produces the benefit. But then looking at how do we using technology, using AI, reduce our cost structure knowing that we're just going to get paid less for the work that we do, it's important to look at synergies and really looking at not just the operating room but the entire perioperative system, everything from SPD to pre and post pacu and really thinking about how do you optimize those very big and expensive assets and optimize it to ultimately reduce the total cost. We've spent a lot of time working with our care teams and our clinicians ensuring that patients that are not in an inpatient status, they have to go home safely and be discharged from our surgical ASU environment. And so we've already been working towards that, knowing what's coming down the pike and I think we're going to be well positioned.
- [10:35]
B
That's great, great to hear and I appreciate you outlining that plan. You also mentioned the big transition of taking three instances of EPIC to one. Can you just speak a little bit more about where Endeavor is in that journey and maybe from your perspective, what you're most excited for once that integration is complete?
- [10:58]
C
Yeah, we're well into that work with about half our hospitals going live in August of this year of 2026 and about the other half going live in November of 2026. So we've been seeding multidisciplinary teams now through for almost two years preparing for this. What it's going to allow us to do, it's going to allow us to allow our patients and our clinicians to work off a singular platform from an access standpoint. It's going to be easier to go to market with the singular service line with singular decision trees built in EPIC to get patients to the right provider in the right location, the right time and have access to the entire network of Endeavor Health. In addition for patients, not only it will allow access to be more seamless, it opens up providers options to providers across our system, especially subspecialists that otherwise it would be hard to. You'd have to go navigate and potentially it might be a little harder to find. It's going to allow our clinicians also to really work collaboratively and more seamlessly. All of our care teams will have access to anything that is done with Endeavor, whether that is in an outpatient site in Plainfield or hospital in Evanston or a surgery in Arlington Heights. And that singular platform allows our care teams to coordinate, collaborate and ensure that we're providing that seamless care across the continuum of care. The US Healthcare system obviously is known to be fragmented and so this is a giant step forward within our health system to make it more seamless. And it's exciting work. Obviously EMRs don't treat patients, but it's a huge enabling step to allow us to deploy evidence based pathways, evidence Based order sets, evidence based research in a big swoop without having to make modifications in multiple places. I think this is going to be a big step forward in the seamlessness of our care that we provide to our communities.
- [13:19]
B
For sure. A huge step towards that seamless, highly coordinated care. Like you said, I want to end here. Taking an opportunity to look at how you're thinking about growth in 2026 and beyond. Curious, from your perspective, what do you see as some of the best opportunities for organizational growth or how are you really defining growth right now?
- [13:42]
C
Yeah, no, we are very much focused on growth. I think growth though is going to be defined on the system level and on the service line level instead of each individual hospital per se. Again, we have, we've moved to singular clinical service lines, singular institutes across all of Endeavor Health across Chicagoland and then ensuring that our strategic and growth plans are aligned with optimizing each service line across all of Chicagoland. And so that is forcing us to really think and make strategic decisions on not what is best for any individual hospital campus, but what is best for a particular institute or service line and by extension the patients that are getting cared for in those institutes and service lines across all of Endeavor Health. And so we are focused on those systemness decisions. And that starts with growing our front doors, making sure that our patients have access to primary care, media care, virtual care to get into our system, and then growing subspecialty access across the service lines across all of Endeavor. That should set us up to be successful not only in a fee for service world, but also as we continue to take on more risk in a value based world as well. So our strategy is well aligned for the headwinds and what the future of US Healthcare is going to, was going to come down the pike. But as you know, Mackenzie, Chicago is very competitive. There's a lot of very good providers. But we are setting ourselves up to be differentiated in the Chicago end market and offer a higher level, more coordinated, seamless, coordinated care across our clinical service lines that really will be world class and allow patients to get care in their communities close to home.
- [15:46]
B
I'm curious, is there a specific decision that you've made recently that you talked about of necessarily maybe what's not best for the hospital but is best for the service line that you could share to help sort of paint a picture for the listeners of how you're thinking about this and weighing it out?
- [16:04]
C
Sure, yeah. We've opened across Endeavor several centers of excellence. I mentioned earlier that one of the projects I led was starting an orthopedic and spine specialty hospital based in Skokie. We made the decision to pull orthopedics out of several hospitals within the Endeavor system, then the North Shore University Health System and centralized care into the specialty hospital. That was a key decision. It helps that our P and L accountability is on the horizontal service line level because if it was on the vertical hospital level, no hospital president would want orthopedics pulled out of their hospital. It's a higher margin service line. So that enabling step of aligning where the accountability is from a P and L allowed us to then make more strategic decisions on how do we develop subspecialized orthopedic care. Similar to our cardiovascular care, we have two large cardiovascular pavilions, Heart hospital at Edward Hospital and the Cardiovascular Institute Pavilion at Glenbrook Hospital. While most of our cardiac care is distributed high volume across all of our Endeavor sites, we have centralized open heart surgery tavrs, high complexity low volume cardiac procedures to those those two sites. Again, difficult decisions. But when what it allows us to do, it allows our teams to get more subspecialized, we can bring in the latest and greatest technology and really double down on doing those procedures, those high complex low volume procedures better than anyone else. So those would be two tangible examples of how we have really elevated the care for our communities.
- [18:10]
B
Great examples. Thanks for sharing those. I think it's always helpful for listeners to get an inside look in some of those strategy decisions. Dave, it's been so interesting speaking with you and hearing about some of the work that you've been doing at Endeavor, how you're thinking about growth, your significant integration efforts, and excited to follow along and see how this work continues in 2026. So thank you so much for joining us on the podcast.
- [18:34]
C
Thank you Mackenzie. Appreciate the opportunity.