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Becker’s Healthcare Podcast
How AdventHealth Navigates Workforce, Operations and Care Continuity
00:24:25
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- [00:00]
A
Hello everyone. This is Erica Spicer Mason with Becker's Healthcare. Thank you so much for tuning into the Becker's Healthcare podcast series. Today we're going to talk about how Advent Health navigates workforce operations and care continuity. And joining me for this conversation, we have Tony DeSantis, the executive director of Procedural and Clinical Imaging Systems at Advent Health. And we also have Ansley Miller, Strategic Account Executive at Insight Global Health. Tony Ansley, so glad to have you both on the podcast. Thank you so much for being here.
- [00:32]
B
Thank you, thank you.
- [00:34]
A
Well, well, before we get into our conversation, I'd love to learn just a little bit more about you both. If you wouldn't mind sharing just a bit about your background and your current work in healthcare. Tony, maybe you can get us started there or.
- [00:47]
B
Yeah. So I've worked in healthcare IT for over 20 years in various systems, healthcare systems and application systems spanning various areas of care. Right now my role is Executive Director of Procedural and Clinical Imaging Systems at Advent Health. I have responsibility for our procedural applications and our clinical imaging applications, as well as various third parties associated with those care areas.
- [01:18]
A
Thanks, Tony and Ansley, please go ahead.
- [01:21]
C
Yes. So excited to be here. I'm our Strategic Account Executive, specifically supporting our partnership with Advent Health. My focus is on delivering staffing, professional services and consulting services to really make sure we are supporting our partnership in the most effective way. And really excited to talk more about that today. So thank you guys so much.
- [01:41]
A
Oh great. Well, I'm really excited to learn a bit more about what's going on at Advent Health and how. Ansley, to your point, your team has supported the health system and I know that through our report at Becker's, you know, we covered Advent Health's EPIC rollout that was completed just a couple of years ago. And we know EPIC implementations are very complex and lumens as part of EPIC is still relatively new territory for a lot of health systems. So I'd love to learn from both of your perspectives what makes these go lives uniquely challenging from both the workforce and an operational standpoint.
- [02:15]
B
Thanks, Erica. So yeah, as you mentioned, we just a couple years ago completed a multi year EPIC deployment across our entire organization. At that point, I think we, during that phase, that design phase, we entertained Lumens as an option, but we were using another system, one that's been around for a long time and we've had. We determined at the time that it was not. The lumens was not at the right maturity and to. To make that move. And I say that because that was, that was A key factor in our ultimate decision. So fast forward a couple years post that decision. While we were still winding down our Enterprise epic deployment, we were following the Lumens development cycle pretty closely and I think it was in 2023 that we determined that Lumens was probably at the right stage of maturity where we could make it work. I think it was going to be an uphill challenge to replace a long standing trusted system with something to your point that's very new. I think we had seen a few examples out in the market where large systems had deployed Lumens and we had heard some positive feedback through that of the efficiencies that were gained. So we structured our project in a way that allowed a significant amount of time for develop design and development as well as awareness. And so we, we put a lot of effort into ensuring that it was a clinically driven project. We had endoscopy experts from our system that were part of a core design group that then they shared design recommendations with the larger endoscopy community within Advent Health. So it was really led and championed by our clinicians and I think that was a key factor. Additionally, once we were at the point where we had a had a functional design, we did a lot. We got out to the sites we did in partnership with our, our chief medical Information officer champion and our teams are in within our design teams within ait. We went out to every site and did road shows on what was changing, what it was going to look like, what the workflows were going to be. And I think that really helped bridge, it helped create awareness for sure. It helped allow people to ask questions and it started to build the foundation of what we would do in the second year of the project which was start to actually deploy across our sites.
- [05:26]
A
Tony, I appreciate the overview. It's interesting what you're saying here about acknowledging that, you know, I guess big system switches or just introducing new tools. It can be an uphill challenge, especially when replacing a trusted system. But it sounds that clinician first approach that you took with the endoscopy experts and kind of relaying that knowledge and those insights across the teams at Advent Health went a long way. And Ansley, I'd love to hear from your perspective too what you observed here.
- [05:55]
C
Yeah, you know, I think everything Tony just mentioned was really important for us to take into account when we jumped in later on from an implementation standpoint for support. Right. Clinician focused. How are we taking in all of that pre planning that was done to ensure that we were not just Partnering from a staff augmentation model only, but for something more. Right. Something that would provide more value. But when we're thinking about a challenge and you know, really where we come in is from more of a workforce or operational standpoint, where we see challenges in this area is more from, you know, a scale perspective. You know, these are often one shot implementations, so, you know, you really have to get it right. And from a workforce standpoint, it's all about people management and alignment. And I know that was a big piece for our team and Tony's team to make sure that we had the right partnership in place. And we were collecting, collaborating on what the right support model would look like when they were deciding to put this into implementation mode. And you know, productivity was a big thing and what Tony mentioned before, making sure that the clinicians felt confident in using the system and that we provided resources that would support in that. So that was a big focus for us as well.
- [07:05]
A
So such a helpful perspective, Ansley. Thank you. And it leads me nicely into what I wanted to ask about next. Tony, I know that you've moved away from a traditional staff augmentation model towards something that's more integrated and collaborative, so I'd love to learn more about what prompted that shift and the challenges that you were aiming to solve in making that change.
- [07:26]
B
Sure. As we looked at scoping out the project again, we were deploying across 56 hospitals and you know, a number of specific labs, GI labs that were going to deploy. So, and Ansley covered this a little bit like the scale of it was massive. So we started small and our model was, we shifted. We were trying to look at how do we, how do we do these big enterprise implementations in a more cost effective manner? How do we, how, how are we, you know, faster to market, how are we more effective in our support and, and doing this all, you know, budget conscious. So we started in a smaller market and we went live with four hospitals and we, we supported that internally with our, in heavy partnership with our informatics team. And as we did that, that model really worked. So what we tried to capitalize on was as we continue to move to bigger and bigger implementations, we ran into, well, we only have so many internal resources, right. It's going really well. The people that know the facilities, know the workflows, know the people are out there supporting the people and, but we don't have enough of those people to cover everybody. And we all knew like the, the, you know, the design could be perfect and the, you could do all the change management in the world, if the support's not there during the go live, it's going to sink or swim kind of on that because people are going to be left with did I get the help I needed or did I not get the help I needed when I needed help? So we looked to how do we take the model that we, that has been working and augment where we had gaps. And so we kind of took a, an approach of filling in like leaning on our internal people and filling in at those facilities where we had a partnership of Advent Health Informatics and Insight Global working together so that they could capitalize on the knowledge that the informatics individuals had and still offer the support to whoever needed it wherever or, you know, we, we wanted one of our goals and our guiding principles for the project was if I turn, if I turn around, I needed to have somebody right there with me. I didn't want to turn around and find no one if I needed help because we wanted, we wanted the support to be on the spot. And so I think that model, there was a lot of factors that factored into shifting that model. Right. And I think it really, I think in the end it really, really worked because you had, you had people coming in and it's hard. And we took an approach of, we trained the people from Insight Global, we held training sessions so they can understand this is what we're doing, this is how the model, this is how we've supported it, this is how we've designed it, this is what we're not doing in case, because you know, people do things differently at different organizations. We wanted people, we wanted them to feel like they knew the Advent Health way. So, and then we partnered them with our local informatics people. And so I don't think we had one area or one location where there wasn't a partnership group between Insight Global and Advent Health IT Informatics on site. And I think that model worked really well.
- [10:56]
A
Collaboration and strong partnership are definitely the terms that come to mind as you're describing that, Tony, and appreciate you sharing that guiding principle too that you had at Advent Health, wanting to have someone there at every turn. So appreciate you touching a bit more too on the Insight Global partnership. Can you say a little bit about why you chose Insight Global as the partner of choice?
- [11:19]
B
Yeah. So again, scale, right. So when we, when we partnered with Inside Global, it was our largest by far, Go live. I think we had 40 plus locations that we were going to be supporting in that go live. And we knew things happen right as you go live, you know, I tell my team all the time like the plan is, the plan is just as is good up until GO Live and then everything changes. So Insight Global offered services, they offered a whole team of people to help coordinate the resources. And that for us was a differentiator because the value that that presented to us in a Go Live of this criticality where change management was huge. And we knew that we wanted the support to be top notch. You know, if somebody had a flight delay or anything, we needed one point of contact to help pivot that. And you know, also Evan Health's a big place, there's a lot of different locations, right. If somebody got it needed, you know, if we had a slowdown at one place but, but a pickup at another place, we wanted the nimbleness to be able to pivot those people. And for my team and my leaders to have to worry about that would have pulled them away from focusing on the GO live overall. So the AD or Insight Global provided a whole team that we could dialogue with and we were all in kind of a, a teams chat together that if we had a need, if we were getting a need reported, we just pinged them and they were immediately on it. So I mean that for us was invaluable and it provided us, it enabled us to be more nimble than I think we had been in previous GO lives where we had staff augmentation present. And so I think, I think the model, I guess if I all things lined up right, we had local AIT informatics support working with the Insight Global team. So we had, we had multiple lines of escalation, both internal through, through our informatics people, through us in the project leadership side. But we also, the Insight Global team that were frontline had an escalation path through that coordination team that got back to us as well. And so not only did it help with coordinating the resources, it helped with the communication. So we all knew what was going on all the time and we had that bi directional communication that really enabled us to be really super nimble with the support. And I think when we made the selection that was the differentiator and it proved in the GO like throughout the GO live it proved to be the value that we anticipated it to be.
- [14:13]
C
If I can say one thing on the Erica, because Tony, I just appreciate you giving such insight into that and you know, this partnership has been awesome. But at the same time, right, we wanted to be very high touch with you all and our role was really to take that operational burden off of Advent Health and off of Tony's team so they could really focus on the go live itself. Right. That is what being a good partner was. And that was our goal from the beginning, you know, making sure that we had the right people in the right place, that we were coordinating flights across the United States and we were making sure schedules were right. We were taking on that burden so that there was strong day to day management and that this would go well. And as we mentioned before, we wanted to think of the clinicians and the physicians and the end users so that it was executed in the right way. So that was our, our guiding light through a lot of this.
- [14:57]
B
Yeah, and, and, and you guys, you guys absolutely lived up to that. I'll even say that to the point. You know, we had, I mean I had a real life example where one of our informatics leaders sent me a text. I think it was like 8 or 9 o'. Clock. I threw something into the chat and one of the inside global people were like on it. And I think the whole thing was resolved within a couple of minutes. So it was like that. That really was amazing for us.
- [15:25]
A
Such a high degree of collaboration as I mentioned earlier. And that just comes through in both of the insights that you've shared. And I know something else that both of you have touched on at one point or another too is just the sheer complexity involved in making a go live go well and successfully. And one aspect that can get overlook in these transitions is what happens to clinical operations while it is in flux. So I'd love to know how you approached maintaining care continuity, Tony, during the Lumens rollout and what structures or guardrails did you put in place to make sure things stayed on track.
- [16:03]
B
Yeah, so we, I'll go back to the. In year one of our, of our two year Lumens deployment, we, we did the road shows. So um, we had the benefit of our CMIO champion also being gi. Practicing GI doctor. So this was, this was very much a passion project for her. She loved it. And we did, they, they went to every location in that first year, every single location in that first year. And they met with the, they met with the, the clinicians, they met with the providers and the nurses. Everyone that was impacted. They, they, they put the time in and they did an overview and then we did shadow charting after with the same level of intensity. We had our informatics team involved. We trained them on the workflows. We, we created awareness like one of our other goals. This was, this was not an official goal. This was like. This was an unofficial Goal, I will say of the project, but I didn't want anybody on day one saying I didn't know this was happening and we didn't have that right. We, we didn't. Our Go Live was fairly seamless, and I hesitate to say that because, you know, as soon as you say something like that, you know, something happens. But our incident count was extremely low for the first couple Go lives. I don't know, I don't know that we had, you know, one or if we got it. We determined it was not due to the Go Live. So it was, it was a very low incident count. Everyone understood that it was happening, everyone understood what the workflows were. And I think the credit of it, like which I'll go back to the things that we had heard before making the decision to embark on this project was that the, the, even though the module was newer, it provided a tighter integration and more efficiency. So I think the clinicians and the providers realized that almost immediately in terms of transitioning. I mean, yes, there's, there's request work that we're doing and people have ideas and, and we're processing through that, but I think the awareness that we created, the commitment to partnering and being in front of the clinicians before, during and after the Go Live around, you know, how it's going, what questions do you have? This is what's changing. That was how we kind of mitigated the disruption of going live with relatively no disruption.
- [18:43]
A
Tony, I love what you said too, about that kind of informal goal about not wanting anyone to be surprised by the Go Live and the implementation. I think it shows a lot about the spirit behind kind of your mentality behind this big transition. And Ansley, I'd love to know what, you know, considering everything that Tony just shared, why is this also crucial from an operational perspective?
- [19:07]
C
Yeah, absolutely. And, you know, the surprise aspect, Tony, there's always a surprise here and there, right? But you got to, you got to be ready for it at any point. But you know, for continuity, you know, our team actually implemented a POD based model for this program which was a little bit different and I think really was a big player in how we were combining the clinical operations side and IT operations side together. So our focus was on, you know, finding SMEs and finding individuals who were clinically fluent who could really speak the language of the hospital staff and just provide that extra value. So from an operational standpoint, you know, we focus heavily on the consistency piece, keeping resources in the same locations whenever possible so they could really, you know, Go to the values of Advent Health and of Insight Global. Right. We take care of each other and that high touch, really learning each other so that this would be successful. Right. And we were adding value in that way too. I think that was a big piece from an operational point of, you know, again, the real partnerships to form and allowing for best practices to flourish so that this could go off seamlessly, as Tony mentioned before.
- [20:13]
A
Great add on, Ansley. Thank you. And I know both of you have already acknowledged how much you both have valued this partnership between Advent Health and igh, but if you could distill it down to maybe one or two things that this partnership between health system, staffing, partner, what has it taught you? If you could sum it up in one or two best practices or insights. And how has that changed the way that you think about partnerships moving forward?
- [20:42]
B
Yeah, so I think the collaboration and the willingness to collaborate, and I say that because, you know, the inside global team kind of really sat down with us and listened to how we wanted the Go live to go, what we wanted the end user experience to be. And I mean, Angeli just mentioned like how that they implemented the POD based model here. Right. So I think that the willingness to adjust and to adapt to kind of what our strategic goals were, I think is, you know, underneath, if I look at the broader category of collaboration, I think that underneath the willingness to flex and the willingness to innovate how we can do this differently and better. I know we've taken a lot of lessons learned from this project and how we roll things out within our own organization and we're carrying that forward. And I think this is the key that how we, how we engage with staff augmentation is one of those key elements. Right. We, you know, we've, we've done it before where we've just done pure staff. We haven't even had people out. And I think this, everyone involved would say this model has gone infinitely better than some of those previous ones because it was a partnership and it was a collaboration at all aspects. From the front line, we had both organizations represented with resources all the way up to us kind of coordinating as a leadership team with the Insight Global Coordination team, allowing us to be as nimble as we could be and really not having really any gaps in the support model. So it definitely caused us to think about how we do things differently and how we can be more effective in all aspects. Right. I think this provided us a way to be a little bit more effective for sure operationally, but also fiscally. Right. I think as we looked at how do we deliver projects more efficiently in all aspects, I think that was a big piece of why we shifted and Insight Global really supported us in that aspect as well.
- [22:49]
C
Yeah, well said, Tony. And I think, you know, that was a big focus for us, just going off of the, you know, fiscally bought there. You know, we wanted to make sure we were supporting with controlling costs and how can we support you guys so that we create a model in a sense. Right. For future cases similar to this. And I think when we're looking at what this taught us too, it just really reinforced what you mentioned before, how important for, you know, partnerships like this, whether it be staff augmentation or something like this, where it was more of a large scale professional service we enacted with you all. But it's all on creativity, agility and the word of, word of the session, collaboration. You know, I think in moments like this, it's success comes from having a partner who can adapt quickly, who can along think alongside each other and really just take ownership of what those outcomes look like and really move on to create change from that. And I, you know, we're very thankful that we were able to do this with Advent Health and with your team.
- [23:46]
A
Well, Ansley, Tony, it's been such a pleasure learning from you both and what really worked in this partnership, especially with the health system, the size and the scale of Advent Health. It's very insightful to hear about some of the practices that really served you all and the clinicians well. So I just want to thank you for your time and for sharing all of your learnings today with Becker's audience.
- [24:08]
C
Thank you.
- [24:09]
B
Thank you. Yeah.
- [24:10]
A
And we'd also like to thank our podcast sponsor for today, Insight Global Health listeners, be sure to tune into more podcasts from Becker's by visiting our podcast page@beckershospitalreview.com.