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Becker’s Healthcare Podcast
Dr. Sriram Vissa, Chief Medical Officer and Vice President of Medical Affairs at SSM Health DePaul Hospital
00:13:16
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
- [00:32]
B
Welcome to the Beckers Healthcare Podcast. I'm Elizabeth Gregerson, a reporter here at Beckers and I'm thrilled to be interviewing Dr. Sriram Visa, Chief Medical Officer and Vice President of Medical affairs at SSM Health, DePaul Hospital on the podcast today. Dr. Visa, thank you so much for joining me. I'm so grateful to be given the chance to share your insights with our podcast audience.
- [00:57]
C
Thank you for inviting me. It's always a pleasure to join the Beckers podcast.
- [01:02]
B
Absolutely. And before we dive in, could you just give us a brief introduction of yourself and maybe tell us a little bit more about your organization?
- [01:12]
C
Thank you. Yeah. So I am a hospitalist, my background in internal medicine and I've been at SSML DePaul Hospital for about 21 years and have been responsible for various leadership roles. DePaul Hospital is part of a large Catholic health care system, SSM Health, which is about 19 hospitals across four states. We are based in the North county of St. Louis. We are a 523 bed community focused hospital with about 2,200 team members and about 1400 providers including doctors and apps. Each year. We care about 20,000 inpatients and about 8,500 observation and recovery cases. We deliver about 670 babies a year. We have about 60,000 ED and urgent care visits. A couple of highlights for our community based ministry. We are the only baby friendly family birthplace center in the North county of St. Louis. We are a joint commission designated comprehensive stroke center and we are also a center of excellence in bariatrics and orthopedic services.
- [02:15]
B
Perfect. Well, thank you for giving us that snapshot of DePaul Hospital. I'd love to know. You know we're chatting right after the new year, but before we kind of look ahead, I'd love to hear about 2025 and maybe what have been the most important initiatives or achievements that you've led at Sabah Hospital in the last year? You know, how did you reach those achievements and what were the results?
- [02:41]
C
Thank you. So I would say the biggest achievement would be our significant improvement in our benchmark rankings in the realms of safety in variations of care, with some continued work underway in efficiency and mortality. We partner with Vizient. It's a large national organization that compares life size hospitals. We are in a cohort called Large Comprehensive Complex Healthcare ministries and about 198 hospitals. Happy to report that we have had a significant improvement within the top 5 percentile in the category of safety and in the top 25th percentile in efficiency and effectiveness of treatment, which would be our significant improvements in length of stay and readmissions. So this would lead us to talk in a little more detail about our length of stay. So our biggest lift was reducing the length of stay by half a day in 2025. And this is not a finance project. More, but more as a patient progression and a care experience transformation. And it really required a multidisciplinary effort from all key stakeholders. It wasn't just one team carrying the burden. We really looked at our multidisciplinary rounding systems, our teams, and created some changes in the way we manage our work every day. We decided to have dedicated team members, including hospitalists, care coordination members, physical therapists dedicated to a floor. So even though teams would rotate week on week off, the same team members would be coming back to the floor. So that team dynamic is built over the four to five months and they would be in a good cadence and rhythm. We also added some noon post round hurdles and a timely escalation of really same day barriers. We also worked on early morning discharges so that we can create that space and the room so that we could decant our ED and bring those patients upstairs as quickly as possible. Because we know that once they're deemed ready for admission, keeping them in ED and boarding them causes more harm and delay in initiation of care. We also used our emr, we use EPIC across ssm and one of the biggest cultural changes we did is to really improve the capture of the expected day of discharge into our EMR so that it's visible to the pet planners, it's visible to the care coordination teams, it's visible to the campus executive team leaders, including the CNO and the cmo and then really validating and seeing how accurate was that prediction the following day. So in our tiered escalation hurdles in the mornings, we would declare how many predicted and how many actually left the hospital and happy to report that the gap decreased from about 70% to about 80 to 85% accuracy in our prediction. As a result, our acute length of stay, we call it the financial length of stay went from about 5.5 to about 4.8 at the end of 2028. So almost a half a day reduction in our length of stay. And this has really improved patient outcomes because the shorter stay patients means safer timely care transitions and fewer hospital acquired risks. And also it increases the capacity to say yes to transfer when it matters the most.
- [06:02]
B
Perfect, thank you. I know our audience loves to hear about results and outcomes, but even more than that, they love to hear how those results were achieved. So I appreciate you kind of listing out for us the exact steps that you took to hit those outcomes. Looking ahead, what are the next big priorities or maybe headwinds that you're focused on tackling in 2026?
- [06:29]
C
Yeah. So our biggest priority would be to continue the length of stay initiatives to improve patient outcomes. We are budgeting additional length of stay improvements in 2026 and making our goals harder. But we want to continue on the momentum we created last year. So we're linking our multidisciplinary round reliabilities, our morning discharge culture and the barrier escalation to a measurable financial and access benefit. The couple of other things related to length of stay would be increasing capacity in our ministry so that we can create more transfers to our hospital. We deliver a lot of complex care in our ministries and how can we help our supporting hospitals by creating that space so that we can be the destination of choice. And lastly, the other priority I would say would be our workforce stabilization. Reducing the code to. Increasing the code to contingency staffing ratio so that we have more dedicated teams that identify DePaul as their primary ministry versus having a larger core group of staffing nurses who would be floating around across the region as well as headwinds are concerned. I would say the challenge isn't launching initiatives, it's the consistency across the units and shifts in maintaining that cadence and the standard work so that we can continue to keep the momentum for improving our performance.
- [07:57]
B
Right. And yeah, I guess jumping off on those headwinds too. As we look into the coming year, is there anything you're anticipating that might be a challenge or maybe the hardest thing that you know is coming down the pipeline that you're preparing for?
- [08:13]
C
Yes. Two things stand out for us in this year as a challenge. The first one would be the toughest operation challenge would be the intersection of limited behavioral health bed capacity and ed boarding. You know, we have about 126 beer health beds in our ministry, but there is significant regional demand across multiple healthcare systems. So we are working on Changing some processes and improving the way we can better provide care for these BH patients and avoid ED boarding times. Currently, our ED boarding time for such patients is about 24 to 48 hours. This creates an unsafe conditions, also exposes our staff towards workplace violence because they are sitting in our emergency rooms. And of course it delays initiating the comprehensive multimodal treatment that is important for our behavioral healthcare patients so that they could get better and go back to the communities they live in. So we are working on some improvements. For example, opening a short term area in our BH with staffing when available to take care of those patients. We are embedding central intake assessors back into ED in person to accelerate evaluations and then also tightening our tear escalation and real time rounding so that we could identify any barriers and place these patients into the appropriate level of care across the BH platform. One thing we are sometimes limited is our two patients to a room situation where one patient may be violent or aggressive or could have some other medical issues that could unfortunately block the other bed and that limits our capacities. So we are looking at opening up some single patient BH rooms in a different hospital across the region so that it could improve the capacity. The second, I would say hardest thing would be really our sustaining or improvement work in mortality. While we continue to work on our length of stay. We are trying to strengthen our palliative care and hospice services so that we can provide the right level of care for complex and end of life care patients. And that is compassionate care and it improves outcomes. So these two would be our hardest challenges for 2026.
- [10:32]
B
Thank you for sharing that. And yeah, I feel like behavioral health and ED boarding and then also integrating palliative care, both of those topics came up so much in the last half of 2025 that, you know, I'm sure our audience will be interested to hear, you know, how DePaul Hospital tackles those in 2026. So we'll definitely have to reconnect again and see how that's going. I know a lot of our audience could learn, learn from your experience to end things. On a more positive note, what do you see are the best opportunities for growth at DePaul Hospital?
- [11:10]
C
Yeah, really. Our strategic growth vectors for DePaul in 2026 would be the following. One would be our destination services and transfers. We really want to strengthen our position as a regional destination for stroke and select surgical specialties and gastroenterology. We are a center of excellence, so we want to expand our bariatrics and orthopedic platforms. With the clinic growth, new programs and targeted provider recruitment, we want to rebuild our complex surgical capacity with recruitment and outreach in neurosurgery and vascular to restore the full platforms. We are the only north county facility that delivers babies, so we want to continue to expand our maternal health and behavioral health services through partnering with our local FQHC clinics and also continue to work on our BH urgent care that provides a good access point for less acute PH patients. Lastly, I would say our primary care footprint as we recruit and hire more primary care we would increase the access points and also innovative models to anchor network integrity and then downstream specialty growth.
- [12:20]
B
Great. Well, I'm excited to hear how all those opportunities go for DePaul Hospital and I wanted to thank you again for joining me on the podcast. I think it's been a really amazing and informative discussion, so thank you for your time and your sides.
- [12:34]
C
Thank you. I would say in conclusion, you know our job is simple to say and hard to do, which is a shortened time to value for patients. When we move care forward every hour through our length of stay, work safely and compassionately, quality rises, access expands and our community wins. So hope I was able to share some of that work we are doing in DePaul Hospital this year.
- [12:57]
B
Yes, absolutely. Thank you again and I invite our listeners to tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com. thank you again Dr. Visa and I hope everyone has a wonderful rest of their day.
- [13:13]
C
Thank you.