Dr. Navneet Dang, Chief Medical Officer at Geisinger Community Medical Center

Summary

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Podcast Episode Summary

Podcast: Becker’s Healthcare Podcast
Episode: Dr. Navneet Dang, Chief Medical Officer at Geisinger Community Medical Center
Date: September 3, 2025
Host: Laura Dearda
Guest: Dr. Navneet Dang

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Episode Overview

This episode features an in-depth discussion with Dr. Navneet Dang, Chief Medical Officer at Geisinger Community Medical Center and physician lead of the Care Without Delay program at Geisinger. Dr. Dang shares insights into the origins, implementation, and early outcomes of the Care Without Delay program, a transformative approach to hospital operations and patient flow inspired by Kaiser Permanente’s successful model. The conversation highlights the challenges and strategies involved in adapting and scaling such a program within a unique healthcare environment and explores its impact on quality, efficiency, and value-based care.

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Key Discussion Points & Insights

1. Background & Vision for Care Without Delay

• Dr. Dang’s Role & Setting

  • Chief Medical Officer at Geisinger Community Medical Center, a Level II trauma center and teaching hospital ([00:46]).
  • System physician lead for the Care Without Delay program ([00:46]).

• Program Origins & Philosophy

  • Inspired by Kaiser Permanente and integrated through Risant Health partnership ([01:52]).
  • Focuses on the philosophy of "do today’s work today, and if not today, why not?" ([02:44]).
  • Challenges the old mindset that care delays are inevitable.
  • Built on 21 foundational elements across 5 categories: leadership, emergency department, hospital care, transitions of care, and operational standards ([03:44]).

• Program Goals

  • Quote:

    "A very comprehensive program really focuses on optimizing access, throughput, and overall quality of care when patients are seen in the emergency department. And I have to say that this program has really, truly been transformational for us."
    — Dr. Dang ([04:59])

2. Adaptation & Implementation at Geisinger

• Local Adaptation Needs

  • Key differences between Kaiser’s environment (mostly health plan members) and Geisinger’s multipayer, tertiary medical center setting—serving 35–40% health plan members, plus Medicare, Medicaid, and uninsured patients ([06:27]).
  • Emphasis on selecting foundational elements that fit the local context; initially adopted 10 out of 21 components ([07:38]).

• Notable Early Initiatives

  • Social Admit Response Teams: Deployed to address non-medical admissions by placing patients directly from the ED to appropriate facilities, rapidly freeing up hospital beds ([08:04]).
  • Seven-Day Operations: Transitioned several procedural areas (gastroenterology, interventional radiology, cardiology) to a full seven-day model to reduce care delays ([09:13]).

3. Outcomes and Impact

• Key Performance Indicators

  • Measured improvements in length of stay, ED throughput, and reduction in ED holds ([10:44]).

  • Quote:

    “We used to have typically 20 to 25 patients waiting for inpatient beds in the hospital at one point. There are days that we have no holds or no patients waiting for beds.”
    — Dr. Dang ([11:40])

  • Despite a 10% increase in ED volume, decreased number of admits holding in the ED, translating to better patient and staff experience.

  • Strong focus on culture and providing staff with the right tools to improve efficiency and patient outcomes ([12:35]).

4. Scaling the Program Across Geisinger

• Expansion Efforts
  • The program has moved beyond Scranton to implementation at Geisinger Medical Center in Danville as of July, and further expansion to the Wyoming Valley location is underway ([13:46]).
  • Emphasis on leveraging learnings from initial rollout to inform scaling across system hospitals.
  • Quote:

    "That is the beauty of being part of a bigger health system, that you can really scale some of these programs where you're able to show that you're able to move the needle on key quality outcomes..."
    — Dr. Dang ([14:42])

5. Future Vision & Collaborative Partnerships

• Value-Based Care and Quality Evolution
  • Strong collaboration with Risant Health and Kaiser Permanente teams, sharing learnings and best practices ([15:49]).
  • Anticipates continued advancement of hospital quality and efficiency standards with a broader community impact.
  • Quote:

    "We are really moving the needle in terms of improving patient outcomes and value based care journey."
    — Dr. Dang ([16:28])

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Notable Quotes

• Changing the Mindset:

  “This program… really focusing on changing the mindset that do today's work today, and if not today, why not? And really getting to the mindset of acting with urgency and removing care delays from happening.”
  — Dr. Dang ([02:44])

• Transformational Impact:

  "This program has really, truly been transformational for us."
  — Dr. Dang ([04:59])

• On Seven-Day Operations:

  "We have been able to move from five day to seven day operations. And that has really helped us to mitigate those care delays and provide that high quality care for our patients."
  — Dr. Dang ([09:13])

• On Staff Morale:

  “Staff loves it because they are able to take care of more patients in a more effective manner. And that also has led to improved patient experience.”
  — Dr. Dang ([12:55])

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Timestamps for Important Segments

• Program Origins & Philosophy: [01:52] – [04:59]
• Early Adaptations at Geisinger: [06:27] – [09:35]
• Outcomes and Cultural Impact: [10:44] – [13:14]
• Scaling to Other Sites: [13:46] – [15:11]
• Looking Ahead & Partnerships: [15:49] – [16:38]

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This summary provides a comprehensive view of Dr. Dang’s conversation about implementing and scaling the Care Without Delay program, highlighting the operational improvements, adaptability, and sustained impact on patient care and organizational culture. The episode is an invaluable resource for healthcare leaders interested in practical change management and value-based delivery.

Transcript

[A]

This is Laura Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Navneet Dang, Chief medical officer at Geisinger Community Medical center and the physician lead of the Care Without Delay program at Geisinger. Dr. Deng, it's a pleasure to have you on the podcast today.

[B]

Thank you, Laura, for the opportunity.

[A]

Absolutely. Now, I know we've got a really great conversation prepped and ready to go here. We're going to talk about Care Without Delay, which is really an important program and vision for some of the things that you're doing at Community Medical center and then looking to scale to the broader Geisinger and Kaiser Permanente health system as well. And so we'll start off with this. Can you introduce yourself, tell us a little bit more about your background, and then describe the Care Without Delay program as well?

[B]

Thanks, Laura. My name is Navneet Dang. I'm an internal medicine physician by training and currently I'm in the role of chief Medical officer at Geisinger Community Medical center in Scranton, which is essentially one of the three larger hospitals in Geisinger. And it's a level two trauma center and a teaching hospital for Geisinger School of Medicine medical students and also various residents and fellows in our Geisinger Northeast Residency and Fellowship programs. I'm also the system physician lead for Care Without Delay program for Geisinger. And thanks for the opportunity.

[A]

Absolutely, my pleasure. So we'll dive right into it. What was the vision for Care Without Delay? Can you tell us and describe some of the foundational elements of the program and what's been so critical about expanding care across the continuum?

[B]

So I would say that as a health system, providing high quality access to care has always been one of our key strategic priorities at Geisinger. And we have focused heavily on making sure that our patients have reliable access to the resources in our emergency departments and in the hospital when they need us. So, and I have been personally working on optimizing throughput across the hospital for more than a decade. But telling you a little bit about the Care Without Delay program, I would say that this whole started with Geisinger's integration with Kaiser Permanente through Risant Health. And I had the opportunity, along with other leaders at Geisinger, to visit Kaiser Permanente facility in one of their hospitals in California. This program, which is called Care Without Delay, was developed by Kaiser Permanente more than a decade ago. This was really built by experienced clinicians and hospital operators and really focusing on changing the mindset that do Today's work today, and if not today, why not? And really getting to the mindset of acting with urgency and removing care delays from happening. And I would say that old thinking was that some of the care delays are inevitable, but with this Care Without Delay program, which is, I would say, a very comprehensive program, is a solution to mitigate some of these care delays. So that is kind of the background of Care without delay and the overarching principle of really doing today's work today that this whole program is built on. There are 21 foundational elements which are really into five categories. There is a leadership category. There is emergency department care without delay. There is a hospital care without delay which has components underneath. And there is a strong focus on transitions of care, which are really important when patients are admitted in the hospital and then they get discharged. And there is also a huge focus on operational standards in terms of making sure that there are escalation processes for our teams and they can escalate some of the barriers or care delays to appropriate leaders. And we are also working on service line agreements between the campuses and the service lines so that there is shared accountability in terms of mitigating these care delays from happening. So I would say, in a nutshell, a very comprehensive program really focuses on optimizing access, throughput, and overall quality of care when patients are seen in the emergency department. And I have to say that this program has really, truly been transformational for us.

[A]

That's amazing to hear. And you know what a really important resource and ability to leverage all of what that program has to offer. Because I know there's so much happening within healthcare. A lot of facilities right now are seeing their emergency departments or hospitals fill up and needing to expand capacity. And so that's really fantastic that you've been able to attack that problem head on, I think. You know how you've described bringing the Care Without Delay program to life in Community Medical center is really inspiring. And what were some of the early considerations or adaptations that you had to make in order to ensure this was going well, and then now, as you're trying to scale it out to the broader healthcare system?

[B]

Yeah, thanks, Laura. This is a great question. I would say that as I mentioned previously, this program was developed by Kaiser Permanente, a group of clinicians and hospital operators who had significant experience in this field. And this has already been deployed across various regions, across Kaiser Permanente, and they have seen significant improvement in patient outcomes. I would have to say that there are some fundamental differences between Kaiser Permanente and Geisinger when we had the opportunity to see this program in action at one of the Kaiser Permanente hospitals. Most of their patients are also health plan members. And when we were trying to bring this program to life at Geisinger and Geisinger Community Medical center in Scranton, which is again a tertiary medical center, close to 300 bed capacity, very busy hospital, we function in a slightly different environment and about 35 to 40% of our patients are Geisinger health plan members. And we really function in a multi payer environment because we have Medicare patients, uninsured patients, Medicaid patients also that we take care of at Geisinger. So we really had to be nimble in terms of adopting this program and also make sure that some of the standard work as part of this program, we are really not breaking that into pieces. So our approach, out of the 21 foundational elements initially we picked 10 components that we felt made the most sense for us. I would like to highlight one of the components we picked is the social admit response teams. And we used to get a lot of patients to our emergency department who did not have any clinical or acute medical issues that we had to deal with, but were purely coming for social reasons. And as one of the key components we put a team together with expanded care management and social worker resources in the emergency department. And the physicians and the care management team work very proactively in terms of placing some of these patients to either post acute facilities or are able to wrap around resources and discharge them right from the emergency room, which has created significant capacity in terms of bed capacity in the hospital. I would say that is one component. The other foundational element is essentially moving from five day a week hospital operations to a seven day week model. And a lot of our procedural areas, specifically gastroenterology, interventional radiology and even some of the cardiology procedures that we were not able to do over the weekend. We have been able to move from five day to seven day operations. And that has really helped us to mitigate those care delays and provide that high quality care for our patients.

[A]

That's great to hear and really important to understand how you've been able to apply some of what has worked with the Kaiser Permanente organization into your local market and situation. And you know, I think I'm curious to understand and dig a little bit deeper in some of the different benefits that you've mentioned. Whether it's improved discharge timing or being more efficient and better utilization of the emergency department. Can you talk a little bit more about the outcomes that have stood out most to you and how you've been able to create the right culture and have the right tools to bring about that success.

[B]

Sure. Happy to. I would say that before we started this work and we kicked off this work about beginning of the year, we really wanted to make sure that we have some key performance indicators that we identify in terms of how are we going to measure success when it comes to implementation of this program. And so some of those key outcomes that we really identified, and we have been able to move the needle, we have been able to improve our length of stay, which is such an important throughput measure and also a financial measure, and we have seen improvements there. We also focused a lot on our ED throughput measures. And we used to. We have been able to reduce the number of holds in the emergency department significantly from. I would say that we used to have typically 20 to 25 patients waiting for inpatient beds in the hospital at one point. There are days that we have no holds or no patients waiting for beds. And when a patient gets admitted, they are clearly getting beds upstairs in the hospital. So I would say that that has really been a significant change. And year over year, as I mentioned, we are a very busy medical center. We see close to 60,000 patients on a yearly basis. And year over year, we have seen about 10% increase in our ED volumes. But because of improved throughput, we have seen reduction in the number of admitted patients holding in the emergency department and causing bottlenecks. And that has really translated into improved patient outcomes also. And staff loves it because they are able to take care of more patients in a more effective manner. And that also has led to improved patient experience.

[A]

That's outstanding to hear and definitely seeing those types of results. I mean, it's really impressive to have the basis and understanding of, you know, what you can do to attack the right problems and then getting the right solutions in place. I know the plan is to expand what you've done at community medical centers to Geisinger more broadly as well. Could you talk about some of those steps that you're taking to ensure those best practices are effectively scaled to other facilities? I know this can be a challenge, whether it's looking at different programs, philosophies, technology, etc. So I just love your sense of what's been important and how you're seeing a continued scale out of the Care Without Delay program?

[B]

Yeah, no, Laura, that's a great question. And when we started this work in Scranton, we really wanted to make sure that we are able to get this program off the ground. And we are also able to move the needle on key quality outcomes. But right now there is another sister hospital, Geisinger Medical center in Danville, which is our flagship hospital. And this program is already live. And we started this work there at, in, in July this year. And we are also in the process of implementing this at one of our another sites in Northeast Geisinger, Wyoming Valley. And that leadership team is actively engaged and working on implementing some of the learnings that we had in Scranton. And that is the beauty of being part of a bigger health system, that you can really scale some of these programs where you're able to show that you're able to move the needle on key quality outcomes to other hospitals in the system and the plan will be to scale it further.

[A]

Got it. That's helpful to understand and definitely fascinating to think about that process. I wanted to look ahead a little bit too before we wrap up our conversation here. How do you envision this partnership between Geisinger, Kaiser Permanente and more continuing to evolve, especially as you're looking to have the next generation of hospital quality and efficiency standards, looking at value based care and more, you know, what do you really see as being the future for or care without delay in the continued value that you're providing to the broader community?

[B]

Yeah, I would say that this whole process, working with our colleagues from Ryzent and Kaiser has been extremely collaborative and Kaiser Permanente teams have been extremely supportive in terms of sharing their learnings and it has been really helpful in terms of getting this program implemented at Geisinger. So I really have to thank them for all the support that Ryzent and Kaiser teams have provided us to make sure that this program is successful at Geisinger. And we are really moving the needle in terms of improving patient outcomes and value based care journey.

[A]

That's fantastic. Well, Dr. Dang, thank you so much for joining us on the podcast today. This has been a very inspiring and informative conversation and I look forward to connecting with you again soon.

[B]

Thanks, Laura. I appreciate the opportunity.