← Becker’s Healthcare Podcast
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- [00:02]
A
The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit, and more, the conversations get real. Leaders will share how their scenario planning for policy shifts brief breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
- [00:46]
B
This is Laura Deardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Prahla Farada, who is the Chair of Surgery at Inova Fairfax Medical Campus and System Chief for Trauma and Acute Care Surgery at Inova Health. Dr. Farada, it's a pleasure to have you on the podcast today.
- [01:02]
C
Hi Laura, thank you for having me. The pleasure is all mine.
- [01:06]
B
Absolutely. Now I'm excited for our conversation because I know there's so much happening at Inova right now and certainly at the forefront of a lot of the innovation and transformation within the healthcare space. And so it'll be great to hear from you about some of the cool things you're doing as well as perspective on the future. But before we dive in, can you tell us a little bit more about yourself and Nova Health?
- [01:27]
C
Oh yeah, of course. So I am a trauma surgeon by training. I am an immigrant. I came from Colombia 25 years ago to this country for training, surgical training. I did research and internship in University of Miami Jackson Memorial Hospital. Then I went to residency at the Beth Israel Deaconess in Boston and I did a critical Care fellowship at Pittsburgh. Then I did another fellowship at University of Maryland Shock Trauma and Acute Care Surgery as our first Acute Care Surgery Fellow. I was at Virginia Commonwealth University for 11 years. Well, I served as Director of the ICU and the Critical Care Fellowship as well as member of the Board and Professor of Surgery. And I joined Inova Health in 2021 as the Division and System Chief for Trauma and Acute care surgery. In 2025, January, I started to serve at Inova Health as the Chair of Surgery for Fairfax. In addition to that, a little bit about Inova Health. I think the reason why I love coming to work every day is the fact that I believe when we talk about psychological safety, it's not a slogan. It's actually something that we leave and breathe. So every time that we think about changing a metric or changing a number or improving in something. I strongly believe that everybody, from the people that work in cleaning the floors or the cafeteria or security, to the clinicians, the healers are at the bedside to the administrators that are working really hard to make sure that we have enough resources to do what we need to do. We are all working really hard for the patients. The patient is at the center of our all, all of our decisions, which fulfills me tremendously because I think that what keeps us as healers, the people that are doing health care, because we wanted to help people, what keeps us going is not losing sight of our mission and our purpose, which is helping others.
- [03:48]
B
That's amazing to hear. And it definitely is so important to keep that mission front and center and have that patient care really at the heart of everything you do. Now, when you're thinking about the last year or so, what was the most important initiative you led, what did you do and what were the results?
- [04:04]
C
Several initiatives in the last year. I think that what some of the things that we have done is basically transformative. Based in culture. Actually we change metrics and now we're doing so much better. But everything is based in cultures. At Fairfax hospitals, we do about above. Above 40,000 procedures per year. And we manage over 50 operating rooms as well as procedure rooms. And surgeons are INOVA employees and Noninova employees. So it's a complex matrix. We improve our first on time start for the operating room from the 50s to over 75%. And that was a lot of work in culture, in communicating well between nurses and surgeons and anesthesia and understanding that we're all part of the same team, we all want the best for the patient. We also improved significantly in any or delays. And as we got faster and efficient, that actually had a better impact in our safety. So when we started looking at safety metrics for the operating room, you would think people were. Some people were a little nervous. Why all the rush? We're focusing on efficiency and by being fast we might forget some things. But it turns out when the work is based in trusting each other, in helping each other, in giving each other the benefit of the doubt. Because we're in an environment where every voice matters and you can speak up and we know that we have each other's best intention at heart, then safety actually got better as well, which was wonderful to see. Then another initiative that we did, but this was an entire healthcare system for the operating room was utilizing Lean Task, which is an AI based program that helps us improve our operating room use. We are using 40% more of the time that was open before. And again, this implies also having a lot of trust between team members, knowing that nothing that you're going to do that is new is not going to, is going to. If you're doing something that is new, people are going to resist sometimes people are going to be afraid of something different, something new. But the fact that we again communicated this well, understood that even though that ENT or trauma or neurosurgery or ortho or general, we don't work in isolation, but actually operating room use, effective operating room use helps all the patients and as the consequence, all the teams. Right. When we work together with each other, the patient benefits, but we also benefit from that cohesive work.
- [07:13]
B
That's amazing to hear and you're really cool that you have the opportunity to change the culture and get yourself into a place where you have that efficiency as well as great outcomes and patient experience as well and having that supportive partners in technology. I know Lean Toss is a great company we work very closely with as well too and has been very transformative in a variety of ways. And so in putting all of those things together, I'm curious, where do you see some of the big priorities as well as headwinds for 2026? What's top of mind for you?
- [07:44]
C
That's an interesting, interesting question. I think that we will continue to work in improved operating room utilization and access for pat urgent cases and otherwise elective cases. I think that a couple of things that I didn't mention, this was what we did last year with the or, but also what we did in trauma is now we have a level one trauma center in Fairfax. Then we were able to obtain a designation for a Level 2 trauma center in Loudoun. So now we have a trauma system. And again and again, literature has been showing that trauma systems save lives. If you are traumatized, you have a trauma of any kind, penetrated or blunt, and you end up in a place where you have a trauma system. Your chances of surviving injuries that other people don't is 20% better if you're in a trauma system. So again, Inova, again with a great initiative and understanding and vision of the mission of serving this population in this community and increasing survival, increasing collaboration. So I think that all of those things are in my mind when we're talking about what the future holds. What I think when we focus in keeping the patient in the center and focusing in basically having strategies that are value based instead of just service based. Right. That's more than a reimbursement strategy. So is a moral sense.
- [09:26]
B
Got it. That's so helpful to understand. And I think especially thinking about that trauma system that, you know, makes such a big difference for patients as they're coming in and can truly get the care that they deserve and have the best chances of surviving and continue to have great quality of life. I think, you know, when you look at building systems of care like that, that's a huge undertaking and something that takes a lot of energy and resources on people side, as well as doing the building and everything else. And so when you're putting those types of things together, what do you do or I guess what's the first steps to coming together as an executive team and really making it happen? I think there's so many health systems right now that are trying to do great things for their patients, but might feel like they've got a little bit of a roadblock when they think about some of the headwinds that you've mentioned today as well. And so how do you just keep yourself focused and come together to create these types of outcomes?
- [10:26]
C
Yeah, that's. Thank you for that question. I think that the number one thing for me is so when you have. When you have your clarity, when you have clarity in your mission, your purpose, your vision, and have that mission, vision and purpose communicated as clear as you see it with the team that is with you, understanding that again, as leaders, I see these mistakes in leadership, not only in surgery, but above and beyond. As leaders, we are serving the team. And there is not somebody that is better or somebody that is less than we are all together in it for. For the same reason, which is making the patients better, respecting everybody's opinion and seeking feedback. Not seeking feedback just to check a box, but to seek feedback with humility. Because every environment is different. And so in some environments, the issue could be that different issues than other environments. Right. So you need to listen exactly what the issue is locally at your healthcare system and respecting the voices that are bringing the concerns to you by not reacting, not retaliating, but taking feedback as what it is, which is golden. Having respect for everybody in your team. And I think clear communication, which is interesting. If you communicate too little, then people start filling the gaps with what they feel or the biases that they bring. But if you communicate too much, people then get burned out from some communication. So I think what we all are trying to continue to try to figure out is. Was the right amount and right way of communication. So everybody understands the same message and we share a mental model.
- [12:25]
B
That'S helpful to know and I appreciate it. It sounds like you've got really a strong system of making sure you can achieve that clarity and then everyone moves forward in the same direction. I'm curious, what do you think the hardest thing you'll have to do next year will be?
- [12:41]
C
I think that there are many things that will be hard next week, next year. I think that there is not one thing only. We all are dealing with the changes that are happening at the national stage and at the global stage. Those changes will have impact in our healthcare systems, in our communities. And those ripple effects, we're going to see some of them this year and some of them in the years to come. And I think that the question is not what are going to be the hardest things to deal with. There are going to be many hard things to deal with. Not only one is how are we going to deal with those things? By again having clear what are your messages? Having clear what, how you want to approach it. For example, what I believe Paula Ferrara is understanding instead of doing fee for service, understanding value care better, right? So instead of asking how many procedures do you do and you're so proud because of the volume, start asking how did this matter for patients? When data becomes a tool to learning instead of like either punishment or praise based on just like volume, right? When teams feel safe enough to surface delays, failures, miss opportunities because that's how we improve. Instead of adding blame or shame to the process, it requires some humility and alignment and continues to be focused on that, continues for all of us to be focused on that. But and also it requires for us to be willing to trade short term comfort for long term trust. But I think if we all as healthcare systems in the United States get this right, I think healthcare will become more human, more sustainable, more honest and again it will become better for patients. Now can I predict what is the worst case scenario? I can't. But I know being an immigrant and living in a place like Colombia, I know, I know for a fact that the decisions are taken at a larger scale in our country and globally will definitely affect healthcare, all of us. And so we just need to be ready and have courage to design path that are going to continue to help our patients in need.
- [15:18]
B
That's such a sobering reminder and especially helpful to understand the gravity of the decisions being made across the the board in the healthcare space and how, you know, you can put yourself into that transformation position. You know, I especially appreciate when you're talking about going from fee for service to more value based care and understanding how the clinicians are thinking about the outcomes they're achieving and the things that they're delivering to the patients. It's truly amazing. Now, before we wrap up, I'm curious, where do you see some of the best opportunities, opportunities for organizational growth?
- [15:54]
C
I think that that's a great question. Are you asking me globally for the country, or in inova? Because I think where I see that it's happening in the United States, we cannot, we cannot deny it. It merges, right? There's. There's tons of mergers, and some of them might be successful and some of them are not going to be successful. We will see. But I think when, again, when, when mergers are for the right reasons, with clear purpose, keeping the patient in the center with a lot of respect for what everybody does in the institutions where mergers, then instead of a hostile takeover, that becomes a superpower, a great strength, right? Or it could be something completely different, but it has to come from the leadership, the respect, the understanding, the ability to come together and again, be respectful also to the clinicians. Right? I'm super lucky that at a Nova, we have a leadership structure where it's not only an administration separate from a clinician, we have a leadership structure that relies on triads or dyads. So you have less chances of having those blind spots because you have people that come from different perspectives bringing different things to the table. And I think that that's. That's the piece that is very important. So every voice really truly matters. Not because you want to have a token of representation of nursing or administration or clinicians of any kind. It's because every voice matters. And I think that with time is going to become more critical. I think places that are run just by administrators, without being in touch with the healers, the clinicians are at the bedside that actually understand what they need to do in order to continue this, to serve patients well and continue by default, keeping a good margin and the healthcare systems afloat. I think if there's a disconnect with that, with clinical force versus administrative force, then we're basically going in different directions. I think that we, even if we speak different languages, I think that where the secret souls are diseases, when we can communicate well with each other, share a mental model and keep. Keep always our north. What is our purpose? To make patients better. I love that.
- [18:37]
B
Dr. Farrada, thank you so much for joining us on the podcast today. This has been such a fun conversation and I look forward to connecting with you soon and seeing you at our April annual meeting. I know we'll be speaking on a panel and certainly will be great to continue this discussion and keep connecting and sharing with rest of our audience. So thank you so much.
- [18:56]
C
Thank you.