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Becker’s Healthcare Podcast
Dr. Amy Thompson, Chief Executive of Covenant Children's Hospital
00:25:48
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A
@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that much simpler. With Athenahealth, see how simpler is healthier at athenahealth.com.
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B
Welcome to Becker's Healthcare Podcast. I'm Chris Sosa, your host and I'm thrilled to be joined today by Dr. Amy Thompson. She's a pediatric hospitalist and the CEO of Covenant Children's Hospital in Lubbock, Texas. Amy, thank you for joining us today.
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A
Thank you so much.
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B
Amy, for those in our audience who maybe not familiar with you and your work, could you please just introduce yourself and give us a bit about your background?
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A
Absolutely. So I always say I didn't want to grow up to be a hospital CEO. I wanted to be a doctor. So that's what I did first. And so I went to Texas Tech University and then followed that with medical school and residency at the Health Sciences center here in Limbo, Texas. I'm a West Texas girl, so I grew up in this area and I became a pediatric hospitalist and practiced in that capacity for many years in my career and loved the bedside, was not really looking to make a change from the bedside. But in about 2013 I actually was approached to become the Chief Medical officer of the Children's Hospital here in Lubbock. Took that opportunity and just an unusual and set of circumstances with a previous CEO whom I adored got sick and so I had the opportunity to stick in or stand in as an interim CEO and then about a year later became the CEO of the Covenant Children's Hospital. And so I've remained in that capacity until about two years ago. I still am the CEO at the Children's Hospital, but now also have responsibility for our adult tertiary quaternary hospital here in Lubbock.
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B
So you're wearing a lot of hats these days. Keep it all straight. Yeah, Amy, you're here on the podcast to talk about several things, but one of them is how I understand that Covenant Children's relational health center. It's a big important part of your efforts to treat patients mental health. So how has Covenant Children's strategy evolved with Respect to this area.
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A
Yeah. This is a topic that's very, very near and dear to my heart. And I say this. This was born out of just many years at the bedside. And, you know, Lubbock is not unlike other places in the country where we just don't have a ton of services kind of in that mental and behavioral health space. And as a pediatric hospitalist, because we don't have inpatient beds here in Lubbock, when I was practicing, a lot of those patients would be admitted to our hospitalist service. So I kind of had this front row seat to these kids that were coming in, in crisis, and we would, you know, send them. Our really our only options were to send them to adult centers that were, you know, nearby, not anything that was child and adolescent specific. And then, you know, I certainly was having, you know, what we all call the frequent flyers. And that's because they just kept coming back. And what that speaks to is that we just weren't able to provide services for them that were actually causing them to be stabilized. And so, you know, when folks are coming back in and out of your hospital, the. The same kid that you're seeing that's been on your service three times from a suicide attempt, that's just screaming to you, we've got to have more services, and we've got to have better care for these kids. So very much, kind of what we wanted to do in this space was born out of that time at the bedside. I was really affected by several people when I was a resident. And there was a. A physician who was a child and adolescent psychiatrist named Valerie Robinson, who has since passed away. But she was just very, very influential for me when I was in residency. And her big thing I talked about, I'm a West Texas girl, and so, you know, I'm from this area. And before she died, one of the things that Valerie talked with me about was really hurt. You know, she was like, I know you believe in this. I know you believe in me making services for these kids, like, promise me that you will do this. What's funny is she said this years before I would ever have the opportunity as an administrator to step into that space. And when I talk about why I've been able to embrace administration, it's because you actually then have the ability to bring to fruition some of these dreams and things like that that you had at the bedside. And so really, that journey that for us, you know, started at the bedside, for me, was really able to come to fruition once I became the chief executive at the Children's Hospital. And we have a great partnership still with Texas Tech University Health Sciences center, with that department of Psychiatry. Got to be good friends with a child and adolescent psychiatrist, Dr. Sarah Wakefield, who is part of that program. And just as our careers both kind of, you know, advanced it, you know, we would dream about what we wanted to do in this space, and then, as you know, luck would have it, I become the CEO of the Children's Hospital. She actually becomes the chairwoman of the department of psychiatry at Texas Tech. And so really, what that did is provide us an opportunity to work together and really bring this into fruition. Your next question should be, why do you call it relational health? Why is that the. You know, like, why. Why is that the thing that we're going to call it? I will also tell you that one of the other things I really learned at the bedside was I just didn't love that stigma that came with, you know, the terms mental health and behavioral health, and especially the way that the kids just would interact with that. And one of the big things that we wanted to do, I did not coin that phrase. I always said Dr. Wakefield coined this phrase, but she. She's told me, I think she read it somewhere. So we didn't come up with this name. But the reason that we really latched onto it and liked Relational health center is mental and behavioral health is all about your relationships. It's about the relationship that you have with yourself. It's about the relationship you have with the people around you. It's also, though, the relationship that you have with your environment and specifically kids who can't control those environments. And just learning that, we want to teach you skills that help you relate better both with yourself, your environment, your world, you know, and how to do those things. And so I'll have to. I can't remember the exact date that we opened up, but what we wanted to do is we wanted to start in the outpatient area. And I'll talk about the reason we wanted to start in outpatient is for that. The way that I described this to you earlier, that when you have these kids that keep coming back, what that tells you is that they're not getting enough outpatient services, they're not getting enough services to help that stabilization when they go from your facility. And so we felt very, very strongly about wanting to start with outpatient services. And really, I say that the vast majority of the brain child part of this was Dr. Wakefield's. And one of the other things that we realized is the time that it took kids to get in to see a provider was very, very long. And so when we were trying to solve for some of the problems with this relational health center, we wanted to a start with outpatient so that we could provide services for kids once they were not in that inpatient setting. And then secondarily, we really wanted to create an atmosphere where we could get somebody in very quickly. And so that was kind of the two things that we put forward forward to want to start with that. I have some statistics if you're. And I'll just talk about. These are actually. Yeah. From 24 and 25, just to give you an idea, you know, what we've done. So the first is when I look at just outpatient completed visits for 20, 24, we did almost 3,000 patients that we saw in that outpatient center. Now, the crazy part about that is that what we also have in the center, West Texas. I don't know if you've ever been to Lubbock, Texas, but where Lubbock, Texas is, is we're called the hub city. And it's because we live in a rural part of our state. They call it the hub city, like the hub, you know, of a wheel. Because a lot of things will happen in Lubbock, Texas, but we have a lot of rural areas that we serve. And so we are part of some programs that are actually out of the. The state of Texas. TCHAT is one of those. And what that allows us to do is that allows us to connect with both school systems. And so when I say this, we are in about 178 school districts across West Texas through tchat. And so in our behavioral health, relational health, I'm sorry center, what we have is we have a. A space where we do tele in there. So we have tele bays. And so we're able to do telehealth and connect with those school districts. And when you look at that, our completed visits that we did with as part of tchat and as part of the school districts was over 10,000. And that just kind of gives you the numbers that in our rural area, we saw about 3,000 of those in person in clinic, but actually almost more than triple that number that we were able to help treat and triage and or get into our services by that connection with the school district. And then I'll kind of talk about where we're headed and then I'll let you ask me any other questions that you have about that. Now that we have been up for a couple of years and we Feel like that we have kind of stabilized some. Some of those outpatient services. The second thing that we really wanted to do was to start intensive outpatient and partial day hospitalization programs that we had. And that's kind of that. That step that, you know, you need something more than just a weekly visit or, you know, something, you need some more intensive therapy than that, but it's still not that inpatient stay. And so we have started both that intensive outpatient and partial day hospitalization, and it's been very, very successful for us kind of providing those services. We recently were actually able to get some funds that we made application for from the state of Texas. I'm so, so grateful that we were able to receive those funds. And so I'm happy to tell you, in fact, this morning in a meeting that I was in, I was able to look at our plans. And so we now have the money that we are going to be able to do the second half of that unit. And we're actually going to be able to open some inpatient beds probably within the year as part of that. So really, really excited about where this is going and mostly excited about the services that we've been able to provide in West Texas.
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B
Amy, thank you for sharing all of that. I mean, it's just incredible how far this program has come in just a couple of years and the fact that you and your colleague are able to put all this together. And as you said, it's got to be just a more of a feeling to be able to say, okay, here's where we were in terms of services for children, West Texas. And now here's where we are. What are some of the early returns that you've had from patients in terms of how you've been able to affect them and bring these mental health and relational services to them?
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A
Yep. I think that one of the most overwhelming things that happened for me, really, actually very early on, I wanted to be there on the day that we opened the relational Health center, and I wanted to meet the first patient that got to come into the area just because it was so exciting for us to kind of see some of this come to fruition. We've had a ton of feedback from kids. The kids love the programs, they love the space. The space. We just lucked out with the brilliance of architects who can go in and just create a space that feel safe, you know, stuff that I never think about. My doctor I don't think about. You know, is this actually a space where a kid who's coming in in crisis is going to feel safe. And so even just a ton of feedback that we've had just on even the architecture and stuff of that space. But one of the most influential things that happened for me, I actually have a very good friend who is a school superintendent, and she has served on our boards. Actually, right now she's on my adult hospital board. And very early on in the process, we received a letter from a mom who was like, I have struggled for years. I haven't known where to go. I haven't. We haven't had any programs. Every time that we would talk about, you know, some of the care that we had single providers in Lubbock who were doing a fantastic job, but just, you know, didn't have all of the services, the wait times were super long. And she said, you know, all the time. My, you know, my hope was to have to go out of town and, you know, to do these things. And it was one of the most heartfelt letters that really affected that superintendent because it was a. It came from a mom that said, I don't know who these people are at Covenant, but I want to give this letter to them because I've been struggling for years with my daughter and just haven't known what to do. And she actually, the daughter that she was talking about was part of one of our intensive outpatient programs. And, like, and I remember her talking about the day that her daughter kind of graduated from that program and just how their entire life had changed. Not just her daughter's life, but their. But their home life. And when you hear those kind of stories, you know, we need more services, but those are the kind of stories that help you understand, you know, the kind of impact that you're having.
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B
Well, here's hoping that it's one of the thousands and millions that come your way before long. I also wanted to ask. You mentioned stigma now to something that every single medical provider deals with in some way, shape or form. So as a hospitalist and now a CEO, do you. Do you feel that's evaporating at some point in some way, shape or form?
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A
I do. And, you know, the reason is because I think more people are talking about it, and I think more people are willing to talk about it. And I have some. Everybody doesn't have to do it this way. But I felt very, very strongly that we wanted to have the relational health center inside of the children's hospital. And part of the reason that I was kind of a stickler for that piece of it is because I didn't want it to feel like this is where the sick kids go. So when you have pneumonia, you come to the children's hospital, but when you have behavioral or mental health, we send you to this other building. And it was just really important for me to say we believe that relational health is part of the health of kids. And it's the same as when you have pneumonia, you need to go to the hospital and get antibiotics. And when you have suicidal ideation and depression and those things, we want you to feel the same about that and not to feel the stigma, to understand it's just something that we can help you with. And we do have not just medicines, but we have therapies and we have these different kind of things. And so I think that that is starting to disappear because I think more and more people are talking about it. And look, I'll be honest enough to tell you, I am a 53. Just turned 53 this week. And look, I'm a person who has dealt with these issues in my life. I've had depression in my life. My husband and I were fortunate and were able to raise his brother. His brother came to live with us when he was 14, and he came to live with us because of a suicide in their family. And so what I always say is part of the reason that you want to destroy the stigma is I always say these are not the people out there that are dealing with the issues. This is us. This is our kids, this is our brothers. This is. And this is me. It's not just these people out there that are dealing with these issues. It's us. And I've just become very, very comfortable sitting in the space of this is our family. And these are the issues that we have had. And these are all the things that we've done to try to work through those. And so I think the more that we have conversations like this where we just call those things out and willing to talk about that, it's not just out there, it's in our families. I think that that's the stuff that continues to just tear those walls down.
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B
That makes a ton of sense. Amy, thank you so much for sharing your personal insights and experiences with that with mental health. Next, I want to give you a chance to discuss some of the other programs, innovations that are happening. So I know you have a transportation kite flight. That's a big deal there. So between that and other projects, what would you like to put on our audiences right now?
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A
Yeah, let's talk kite flight. This is also one of my. One of my favorite things this is not necessarily innovative. There's a lot of folks. I will say it was innovative for West Texas because of where we're at. And I always talk about one story that I share when I was at the bedside is there was a rural community. It's a couple hours from us. They had called me about a kid that had a simple. We call it a cellulitis. It's a skin infection. And appropriately, you know, unfortunately, right after they called me to transport this kid, there was a woman who came in that was having a heart attack in the same community. Well, they've got one ambulance, and so they made the appropriate decision, sent the woman, you know, in the ambulance having a heart attack. But then by the time the kid got to me, it had been about nine and a half hours. And so from the time that they originally called to when we were able to free up EMS and get that kid here, the kid was something that we call sears, which is a systemic inflammatory response. And I say he was on his way to sepsis because it just took so long in transport. And I have numerous cases like that over my career. And so one of the things that we knew that we had to do was, was to step into that transport space. So in 2018, we started just with an ambulance, and we've always done neonatal transport. We've always used local services here. But again, you're kind of in this queue of having to wait for when those helicopters and those things are free. So in 2018, we started a more comprehensive transport program that include both neonatal and pediatric transport. We started training that transport team. About a year later, we were able to get a helicopter. And so we actually have a helicopter. We lease it. People are always like, how did you have enough money to buy a helicopter in healthcare these days? And the answer is we lease it from somebody who knows how to take care of it. But it is a Covenant Channel children's helicopter and just had great, great response from the community. We had some folks that helped us build a hangar. So now what I have now is I have. I have both a neonatal team that I have both nurses and, you know, respiratory therapists, EMTs that are part of that team. I have a pediatric team who does, you know, kids that are outside of that neonatal period. But then what we have started most recently is what we call hirob, which is a high risk OB transport service. And so I use some of our women's personnel. So we also now have the ability to transport moms. And when you look at the growth that we have had as part of that program, it went from a few hundred the very first year that we did this to over 900 in this year. So it's just been an exponential growth. And we're. What we're seeing is just our ability to get to kids quicker. And even doing things like the hangar allows us to take off directly from the hospital. And man, when you're taking care of a kid that needs ICU status, cutting off four minutes of transport time is huge. Every time that we're able to cut down that time. I'm going to give an example In West Texas, unfortunately, health care across the United States has really taken a hit kind of post that post Covid time has been really, really hard. And as we see more and more hospitals struggling, unfortunately in West Texas, a lot of them have stopped doing OB services. And so that's part of the reason we wanted to start this high risk ob and just to give a flavor for that across West Texas. One month ago, we transported 19 moms from our region that were in hospitals that didn't really have access to, you know, either. Either any OB services or certainly, you know, not high risk OB services, you know, and of that, 12 of those kids ended up in our NICU. And so, like, it's just, it's really filling a void in West Texas in terms of the ability to go to get people. I always say Lubbock only has about 300,000 people in it, but we serve an area that is about the size of the state of South Carolina when you look at the land mass. And so having this transport team for us and starting that program has really been a differentiator for us just in the ability to go get both kids and women as part of that. So super proud of what we've been able to do in that space.
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B
Yeah. One every other day, more or less.
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A
That's crazy.
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B
Yeah. I'm just glad that they're able, that you're able to provide that now, whereas before it was not possible. Lastly, Amy, I simply want to ask you, I like to give our guests a chance to discuss other things that might be on their mind. So simply, what aspect of healthcare, whether it's related to pediatrics or not, do you think deserves a brighter spotlight? And how do you and Covenant Children's fit into that?
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A
Yeah, so we were actually discussing this. I thought that was the hardest question that you posed to me was, you know, what's the other aspect of healthcare.
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B
That you think there are always plenty of them, right?
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A
Yeah, there's always Plenty of them. And you know what? You know, after talking with some folks that were in my office about it this morning, what I decided that I'm going to say on this is actually I'm not going to talk about a program or, you know, a service that we're doing. I lived through Covid. I both was at the bedside during COVID and also was a hospital administrator during COVID I've seen the after effects of not just, you know, Covid, but also I call that post Covid world. It's our caregivers. We call all of our employees caregivers because we believe that everybody that works at Covenant Health takes care. Whether you are touching the patient or not, if you're in the billing office, you still have part of that care. And look, this is the hardest environment I've ever seen in healthcare in these last, you know, really 12 years. And, you know, I. When people say, how did you, you know, live through Covid? Listen, I'm not trying to minimize Covid. Covid was. Was one of the hardest things we ever dealt with. But I'm not sure that what we're experiencing right now in that post Covid era is any easier just because, you know, there's diminishing, you know, returns. There's, you know, inflation is high. And I just think we've just never had a. Of sense much stress as we have right now for our caregivers. And so when I think about, you know, what, what deserves a brighter spotlight, it's the people that actually each and every day are standing at the bedside and. Or working in our hospitals. And I just think we have to continue to have that conversation about how we honor the people that are doing this work day in and day out and make sure that we're not burning them out, especially in this very hard kind of post Covid environment. So I think that we've got to figure out a way that we can pay people what they need to be paid, but also celebrate people in the way that they need. And, man, we have a long way to go in this. Even at Covenant, it's something that's important to us. And so I want to continue just to grow in that because I know how important that is for our caregivers.
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B
Amy, I think that's the perfect place to end. Thank you for covering all this ground that you did today. I know I learned a ton. I know our audience will feel the same. Thank you so much for sharing your insights, and I look forward to the next time our paths cross.
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A
Awesome. It was so Nice to meet you. Thank you so much for having me.
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B
Thanks, Amy.
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A
At athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom lines. Practicing medicine is complex, but running a practice can be that much simpler with Athenahealth. See how simpler is healthier@athenahealth.com.