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Becker’s Healthcare Podcast
Leading Pediatric Orthopedic Excellence: A Conversation with Matt Chance
00:23:08
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- [00:01]
A
The Beckers team is excited to announce the launch of our new CFO and Revenue Cycle podcast. Tune in for conversations with finance experts from the top hospitals and health systems. We'll discuss key trends and ideas to drive meaningful change in the industry. Look for Becker's CFO and Revenue Cycle podcast wherever you listen to episodes. This is Laura Dardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Matt Chance, senior Vice president and Chief Operating Officer of Scottish Rite for Children. Matt, it's a pleasure to have you on the podcast today.
- [00:37]
B
Well, my honor, thank you for the invite and looking forward to sharing some of our story here at Scottish Rite.
- [00:44]
A
Absolutely. Well, I'm looking forward to it, too. I know you've got some really great things happening, and Ben will be excited to know what's ahead and in store for the next year or so. But before we dive in, could you tell us a little bit more about Scottish Rite, what makes it unique?
- [00:58]
B
Yeah, that could probably talk for a good hour or two about what makes Scotch Rite unique. But just to kind of hit some of the highlights, Scottish Rite is really, it's been here for over 100 years here in the Dallas area. We are a pediatric orthopedic hospital. And so I'll share a little bit more of the clinical scope, but some of our history here. We've been on the same side for over 100 years now. The hospitals actually started in 1921 by a group of Masons who noticed this was during the polio pandemic, that there was a group of pediatric patients that were not being treated for polio. So they approached the only orthopedic surgeon in town at the time and asked him if he could devote some time to seeing peace pediatric patients. And he agreed. And so on Saturday mornings, he started to see patients in his clinic, pediatric patients. And so by the first month, every Saturday was so full of patients that the Masons then decided to go ahead and fund a full hospital. So they started constructing a hospital that was built the next year in 1922. And so it started with those pretty humble beginnings treating polio and really continued until polio was eradicated in the 50s and 60s with the sulk Sabin vaccine. And so the hospital then shifted to a broader clinical scope of pediatric orthopedics. And so we've now really, our primary diagnosis is scoliosis, and that's curvature of the spine. But but really we see any pediatric orthopedic condition that really ranges from complex foot and ankle conditions to hip conditions, both Congenital and trauma related limb lengthening. Really interesting limb lengthening conditions where the child may be born with a limb difference. And it really develops some expertise here to treat patients and actually lengthen those limbs. We've got a couple of hand specialists and then probably our fastest growing subspecialty is sports medicine, where we treat patients that are athletes that are in various ages that are trying to get back on the field. So we have sports related injuries, but also some injury prevention as well. So the hospital really is here in Dallas, Fort Worth area. Our main campus is again, been here for over 100 years, but we've got a couple other satellite locations in the northern suburbs of the Dallas market. But really we see referrals and patients that are referred to us really from across the country and internationally for the expertise we provide.
- [04:08]
A
That's amazing to hear, you know, and certainly I'm just excited to see that transition and then being so valuable to the community at large. I know having that opportunity for kids with Sydney injuries or disorders or other musculoskeletal challenges makes a big difference. When you think of the last year, what accomplishment are you most proud of?
- [04:31]
B
You know, I think we're always focused on trying to find ways to improve the care we provide, improve the experience. And so that's always something that we're trying to improve on. This year in particular, in 2024, you know, we participate in the U.S. news and World Report rankings. And so for the pediatric orthopedic category, we actually jointly submit with one of the other children's hospitals here in town. Our doctors actually cover the emergency and trauma coverage at their facility. And so we jointly submit and this past year we were ranked number two across the country for pediatric orthopedics. So that's just a very high level award, but recognition for the to day expertise that we provide. And it, you know, really, it, it does certainly take a village in order to achieve those national rankings, but it really is every single day, you know, providing the best care, best experience for each patient. Family walks in the door.
- [05:39]
A
That's amazing to hear, you know, and congratulations on the recognition. I know that doesn't come easy and takes a lot of teamwork and effort. And I like the fact too that you talk about not only clinical outcomes being elite, but the patient experience as well. Look at 2025. What are some of your big organizational goals that will set you up for continued success?
- [05:59]
B
Yeah, you know, that's, you know, patient experience again. It's one of those. We always are monitoring patient experience. We actually have consistently ranked in top scoring pediatric hospitals for patient experience as well. So that's sort of a routine goal. But I think here locally we really are trying to make some decisions on inpatient capacity. And I mentioned we have a couple of suburban satellite facilities that are strictly outpatient focused, both clinics and surgery center focused. But our main hub here in the Dallas, in Dallas does have inpatient beds. And it's. The space itself is a little dated. And so we're trying to kind of make some decisions on the size and scope of those inpatient beds. I think that that's going to really help us clarify kind of our patient population going forward. And then, you know, I think some of our challenges are our goals are similar to others. Across the country, we're really evaluating artificial intelligence and really wanting to make sure that we are exploring and experimenting with AI, but also making sure that we tailor it to our environment and our patient population, the care we provide. And so trying to, we're, we're use EPIC as our electronic medical record and, and so trying to evaluate some of the AI tools that EPIC is starting to roll out and experiment with. And so just trying to figure out exactly which direction we're going to proceed with implementing that technology.
- [07:53]
A
That's really helpful to know. And I know especially in the last year or so there's been a lot of that focus on AI. A lot of new opportunities in the field is changing pretty rapidly. So, you know, Scottish. Right. When you're looking at AI and some of these different opportunities, I can imagine it can almost be overwhelming given the breadth and depth and scope of some of these things. So how do you wind down or narrow down what it makes sense to start trying and then doing within the organization?
- [08:23]
B
Yeah, you know, that's a real challenge. I mean, I'll be honest, it's. It really. We're starting with an AI governance group that is essentially a multidisciplinary group of clinicians and staff and administrative folks from various areas and helping in research as well. You know, really trying to identify the most likely applications for artificial intelligence across the facility and really trying to start with, you know, broad categories. I think universally one of the areas that, you know, really pops out immediately is really just trying to reduce the administrative burden of clinical documentation. That seems to be, I think everybody's in favor of that. We've actually been using an ambient documentation system in the room, in the clinic rooms with several of our docs with great results. And so I think probably right after, at the beginning of COVID we kind of Shifted away from physical scribes into an ambient listening type program and really have been working with a couple of vendors to continue to revise that technology. You know, sort of category is just trying to reduce some of the administrative inefficiencies that we all have in health care. There's still a lot of paper pushing a lot of manual, you know, pre authorizations for care and verifying insurance plans and viabilities and things like that. I think there's lots of possibilities for working with some of those. Just trying to again, reduce some of the administrative burden on the back end and then research, you know, we've got it. We're an academic facility and so have a lot of really bright academic minds who have, who are exploring, you know, clinical research and in various different pathways. And so they're, they're crunching data, you know, working with our internal, you know, data scientists to really investigate some of their hypotheses and so trying to use AI to help expedite some of that. That basic research and clinical research is really another category that we're exploring. But it all starts with, you know, again, that AI governance group that's helping us, you know, put some guardrails around it. I think everybody's interested in exploring it, but at the same time cautious to that. You know, we're, we're, you know, going down a pathway that's appropriate for our facility, but also being respectful to our patients and being cautious about, you know, patient identification and privacy as well.
- [11:29]
A
Absolutely. There's a lot to think about there in, you know, many different aspects of having AI in the healthcare space. It's great to hear you've got that governance group in workforce with both clinicians and administrators because it takes all perspectives to really make this go well.
- [11:47]
B
It seems like, yeah, it's definitely one of those projects that it is a cross pollination of clinicians who can describe some of the challenges they have every day and then also interface obviously with our patients. Yeah, I guess that's the other category too is, you know, identifying ways to provide more or to improve the patient experience. And if that's communication, you know, trying to expedite responses or if it's helping our patients navigate the pre surgical process or whatever, you know, just finding little tools that, that appeal to our patient populations as well. You know, within pediatric health care, the patients are always going to be young patients and so typically their parents or their caregivers are young and tech savvy. And so that creates a little bit more pressure for us to stay ahead of the game and rolling out tools that our families are going to be willing to use. And more and more families have less patience for picking up a phone and talking somebody waiting on hold, talking somebody online they'd much rather use, take advantage of some of those digital tools to get some of their questions answered.
- [13:13]
A
That makes a lot of sense and is really great insight, especially given the patient population that you serve. Now I'm wondering we've talked about a lot of the different opportunities out there and things that Scottish Right will be considering and diving deeper into for next year. But I'm wondering as well, what are some of the headwinds that you have your eye on are troubleshoot as time goes on?
- [13:36]
B
You know, I think there's some newer headwinds, but also some that we, you know, sort of manage around and navigate that are not new at all. But probably the most pressing and really the biggest mystery is just some of the, you know, some of the political climates at both the federal and state level trying to understand kind of what the impacts of new offices being held and kind of some of the restrictions around some of the funding sources. You know, one thing I failed to mention at the beginning of the when you asked me to describe the facility, we truly treat any patient, regardless of their ability to pay here at Scottish Rite. And so we are dependent on, you know, supplemental funding from the federal and state levels to help us treat some of those patients. And really some of our other healthcare colleagues out in the community, we really see or we treat a narrow niche of the patient population. But a lot of the hospitals, both in the pediatric and adult markets, rely on those supplemental payments as well. And those have been somewhat on the precipice of change and threats of, you know, going away for several years now. And so that's a concern is whether or not there are going to be changes, you know, both at the federal and state level that will impact some of that funding, but also some of the care being provided and even some of the regulatory agencies that govern what we do every day. And the reality is there are patients and families that are impacted by some of those changes. And so that's always something. And we we monitor closely and make sure that we can help some of those families navigate to. Yeah, I think one of the other headwinds here in the North Texas market that is unique or maybe different than some other areas of the country is we are the population in Texas is expanding and growing and booming really is probably a better description. So really what we are challenged with is really managing that growth I think the pediatric population here in the North Texas area is predicted to double by 2050. And so how does any healthcare provider kind of manage that kind of growth? And then for us that is focused on a niche patient population. Do we continue to treat just our niche? Do we narrow further? Do we expand? Do we, you know, continue to focus on inpatient care or do we expand our outpatient footing? I mean, those are some of the challenges that we were kind of navigating and trying to kind of figure out as the population grows, how do we grow and really, you know, grow with that market. You know, then I think other common headwinds that other facilities do manage as well is just kind of the recruitment and retention kind of general workforce challenges we are mentioned. We are a very, very sub specialized provider. And so all of our physicians, nurse practitioners, respiratory therapists, nurses, you know, athletic trainers, are very, very specialized in the patient populations that they have expertise on, our expertise with. And so I think they, we are challenged as we grow and add staff that we maintain the same bar of excellence. But that requires us to find kind of unicorns out in the workforce market. We're very fortunate here and that because of the deep culture we have here at the hospital, we have a very, very low turnover and vacancy rate. We're essentially at single digit turnover rate for both all staff. And even more impressive is our nursing turnover rates. We have a 6% nursing turnover and that's great. It's great not to have to constantly replace talented staff. But that means when we do, it's again difficult to find the level of expertise we're looking for. And so that's a real challenge. Here in the state of Texas, most hospitals cannot employ their physicians and we are grandfathered into that capability. And so we do employ our physicians. And we are challenged, just like many other pediatric providers in that we are challenged to find radiologists and anesthesiologists and and some other very, very specialized pediatricians as well. So those workforce challenges are always an issue for us. And then finally, the other one that is a little different than some of those other headwinds is just some of the security related challenges. Obviously, cybersecurity is a challenge for every healthcare provider. You think that healthcare is immune to cyber criminals, but really not. And so we've invested heavily and continued to protect ourselves on the cybersecurity front, but also campus security. We for the first time last year did an active shooter drill that was well orchestrated, we planned, and really very thoughtful in how we delivered a man active shooter Drill on, on both of our campuses and, you know, no one enjoys doing those, but that's the reality of healthcare these days. You know, having to constantly be concerned with violence on your campus is a challenge for all of us. And so we're proactively planning for the that eventuality. And just also, in addition to active shooter planning, also just how to diffuse situations in going through training and education for a lot of our staff members who can hopefully diffuse some of those challenging conversations as they occur.
- [20:26]
A
Absolutely. Well, that's a lot to cover and think about, especially looking through not only the challenging political environment, in many ways really posing some issues, especially with how Medicaid is continuing and will progress. And then as you said, interesting to think about, you know, the booming population in Northern Texas and how you're able to respond to that very, very specific workforce and, you know, challenges as well and thinking through how to get that expertise into the right places. And so I appreciate this very thorough analysis of everything that you're working on and coming through. So given those challenges with our last minute or two here, how are you evolving as a leader to make sure you're rising to what your team as well as the community needs from you in, in building a thriving organization?
- [21:17]
B
You know, me personally, you know, I, I guess I'm probably entering more of a strategic phase of my career. I had a mentor earlier in my, my career that kind of mentioned you kind of go through these phases where as a young early career, so you have a, you build your expertise with your technical knowledge and then you kind of, as you're expanding your sphere of influence, you're influencing staff and really leading individuals. And now, yeah, I'm really more focused on strategic direction of the organization and trying to provide clarity there. But it's also influencing outside of the organization, outside of Scottish Rite. So trying to be more proactive about doing things like this and you know, working on with other organizations, other healthcare and hospital associations and groups, you know, serving on boards and participating locally and at the state level and various groups that are trying to educate future healthcare leaders, but also work with each other to help solve some of these daily challenges we all have.
- [22:32]
A
I love that. I think it's just such a great way to think about how you're continuing to grow and evolve into this role and then to looking at leadership. I know there's many others likely in the same situation, seeing themselves take that strategic turn as there needs to be a big transformation within the healthcare space. Thank you so much again for joining us on this podcast, Matt. I really appreciate the opportunity to speak with you, learn a little bit more about what you're doing at Scottish Rite, and I look forward to connecting with you again soon.
- [23:00]
B
Okay. Thank you so much, Laura. I appreciate the time and interest and would love to share more of a story about Scottish Wright.