← Becker’s Healthcare Podcast
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- [00:01]
A
At Vitility, we're transforming health care to improve lives. As a physician owned, multi specialty partnership, we put patients first in every decision. With 6,000 clinicians caring for over 10 million people each year, we lead with innovation to make care more connected, more responsive and more human. Learn more@vituity.com.
- [00:30]
B
This is Laura Dardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Saad Etesham, who is the president and Chief Executive Officer at Atlantic Health. Saad, it's a pleasure to have you on the podcast today.
- [00:42]
A
Good morning Laura. It's a pleasure to be here with you.
- [00:45]
B
Absolutely. Now I appreciate your time and I'm excited to dig into some of the cool things that you're really doing today and, you know, what you're looking forward to in the future. But before we dive in, I'm curious, can you tell us a little bit more about yourself and your background?
- [00:59]
A
Sure. My background, you know, my journey to healthcare started at an early age really. The impression on wanting to be in health care was related to my grandmother's battle with ovarian cancer and how she was treated and cared for. So that left a lasting impression on both my brother and I, who's now a neurointensivist. So that was the genesis into the why in healthcare and it was a summer job. It was only supposed to be a summer job. I was 20 years of age in Dallas, Texas and the heat in Dallas and Texas is just, I mean it is crazy. So summer job turned into a PRN all year round job while I was an undergraduate at Baylor University and during that two years working as a phlebotomist, a summer job into PRN, the CRNAs, the nurse anesthetists convinced me to go to nursing school. And so upon graduating I went to nursing school and became a nurse. I ended up being an open heart nurse, charge nurse, house supervisor at Presbyterian Hospital of Dallas. That led to a job in a for profit world as a director of nursing of medical and surgical units. And during that time I had gotten my master's degrees as well. So truncate that a little bit. I've been on the for profit side and the not for profit side. On the not for profit side I've been some larger healthcare systems that you may know of. Baylor, Scott and White, before the Baylor, Scott and White merger, Texas Health Resources, Ascension Health, and then on the for profit side I've held CEO, coo, CNO type roles. I've been in a C suite for the last 22 years and most recently coming from Novant Health to at Clinic Health. I've been in small hospitals, 98 beds all the way to a coronary thousand bed hospital where it was a level one trauma transplant burn center with lots of research in GME UME programs. So that's my background. And what led me to Atlantic Health was the desire to be at an organization that embodied the values of focusing on their team, focusing on the community, commitment at the highest level to quality and safety outcomes. I needed an organization that had complexity and so research was very important to me and Clinic Health had that. We have almost 446 trials that are underway. We got 148 peer reviewed publications, 46 investor initiated studies going on 37 million in grants. And then two really proud of that, two physician led FDA approvals. So that was important. And then also graduate medical education and undergraduate. We have about 350 residents at Atlantic Health. And then the board, the board was just fantastic as a competency based board. So I was looking for that. So all those things culminated me saying that's the right place and that's where I want to come. So that's why I chose Atlantic Health.
- [04:09]
B
Absolutely. That's an amazing story and you know, really truly coming into healthcare and at the ground level and then seeing how you built your career around serving patients and serving others, being part of the really important growth within communities that healthcare institutions serve. And so that's great to hear and I appreciate too you walking us through the decision to move from Novant to Atlantic Health because I think it's critical and especially now, you know, there's so much riding upon healthcare leaders today that it's important to find that right culture fix and the fit in the right organizations in order to make sure that you can thrive in your career as a healthcare leader. So from your perspective, I know you've just joined Atlantic Health in July, but could you tell us a little bit about the health system and its biggest win or success story from the last year or so?
- [04:59]
A
Sure. Clinic Health is a combination of six hospitals. We got 24,000 team members. We serve a population. New Jersey is nine and a half, nine million. We serve a population of 7.5 million across 14 counties in New Jersey, one in Pennsylvania as well. We got over a million unique encounters across 550 sites of care. We have more than 7,700 affiliated physicians. We have the largest ACO in New Jersey, if not the Northeast, that I'm validating that, but definitely in New Jersey. And then I talked about the trials, our hospitals if you look them up, Morristown Medical center ranks among the best in the country by U.S. news & World Report. And same for Overlook as well. So that's where we are. But what makes Atlantic Health unique really is the culture, is the people, and it's the commitment to the community. And you measure that through a proxy lens of the foundations. And how successful are our foundations. And our foundations have a long history, sustained history, philanthropic support from the community. So Atlantic Health is thriving here in northern New Jersey and it's seen as one of the best health care systems in the state of New Jersey.
- [06:24]
B
That's amazing to hear and really a testament to the commitment of the whole team for greatness and then to just building on how they can serve the community better on a consistent basis. Now, I know it's a unique time in healthcare right now. And so I'm curious, from your perspective, what are the top two or three issues you're focused on right now? What's top of mind for you as you're making decisions for the future?
- [06:47]
A
You know, as a healthcare organization, much like other healthcare organization, we're facing all similar challenges from the policy impact. How did we react to that? And my approach is instead of letting the environment control us, we're going to take our approach in controlling the environment and the controllable. So part of that is redefining how we deliver care and iterating around that, using opportunities that we see around population health, how we can advance care around population health. We know there's going to be vulnerable populations in the future that are going to seek healthcare costs and needs. And before those individuals show up in care settings that are not the most appropriate for them, we want to reach out and establish care for them in the zip codes where they reside. So that's very, very important to us. Advancing the mission and brand of Atlantic Health nationally and internationally is something that's very, very important to me as well. And then we're in the election year, so working with whoever is elected our governor at the great state of New Jersey, working with them and along with my fellow CEO colleagues in New Jersey, when we look at the graduate medical education report that just came out, we have about close to rounding up 1600 residents that are graduating. Only 474 of them are staying in the state of New Jersey. Rest of them are leaving the state. So that's a big issue. Retention is a high priority for us. So I look forward to working with our governor and my fellow colleagues and finding ways on how we can incentivize the residents to stay and care for the population and the citizens of New Jersey. So that's going to be important for us as well. And for me, talent development, upscaling and upskilling our team members, leadership development and retention is going to be important. There's a bull work on talent. I feel we have some of the best leaders within Atlantic Health and it's my job to create an environment where they're thriving and there's opportunities for them to grow within the organization. So we'll, we'll continue to focus on that as well. And then more importantly for us is codifying a common vision around quality and safety outcomes, consumer experience, population health, physician alignment and integration. And goes without saying, financial stewardship and performance is going to be very important.
- [09:15]
B
Absolutely. No, I think all of the elements that you talked about there really essential and something that make a big difference for the success of health systems overall. And I wanted to double click on the talent development, retention and just workforce issues that you talked about. I'm curious, as you look at your past experiences as well as some of the dynamics in today's current environment, what do you see as being some of the things that will be most essential to creating that kind of organization where you are winning that war on talent? For example, how are you thinking about building up the leadership pipeline and just making sure that the whole system is solid, moving into the future or.
- [09:59]
A
I just love that question. One of the things that hasn't changed over over the many years is the team member leaving. The organization is directly tied to their immediate one up, their immediate supervisor. 43% of the time people leave is because of their immediate supervisor. And now today's environment where we're dealing with six generations, the millennials in Gen Z also want to know where does the organization stand on major issues. So that's very important to them and a sense of priority purpose. So it's important for us to have leaders who understand how to navigate the generational odyssey of six generations. And the value systems are very different from baby boomer to a Gen Z. So we spend a lot of time educating them on engagement of that workforce. We do talent development for our emerging leaders, which is supervisors and assistant managers and above. In fact we just had one a couple of days ago. We had 396 leaders in person and another 300 on Zoom. And we had a full day packed with opportunities for them to learn how to become a better leader. So that's something we're doing as well. The other thing we have launched is succession planning. Within the organization at all levels, it's important to have a bench that's two, three deep and that creates stability as well. And if for some reason somebody leaves the organization because of the talent that we have in their post, which is okay because we're preparing future leaders in health care, we have a bench that we could go into and sports analogy, get somebody from AAA into the majors. So that's how we're focusing on talent development. And then it really comes down to the culture, the culture where people want to work, where they feel like a family. And it's important for us to create an environment where people feel they're heard, their opinions are valued and their one up cares about them. If you can create that environment, people are going to want to come work for you. And we've been fortunate enough to be on the Fortune's best places to work and healthcare list for many years and also Fortune best places to work general in all industries for 16 plus years. So very, very excited about that history that Atlantic has and commitment to our team members.
- [12:24]
B
Absolutely. That's amazing to hear and I really appreciate the focus on having that very clear, robust bench of leadership and then being able to think about succession planning in a meaningful way. One other thing you mentioned as well, there is just looking at the financial stability and understanding what it will take in order to keep the organization financially secure over the next several years here. So how do you think about that? I know there's so much uncertainty within the broader healthcare as well as economic and political landscape. And so how do you plan for the near term as well as the long term in deal with the very real challenges that a lot of healthcare organizations have today.
- [13:09]
A
The approach needs to be future proofing the organization to face any headwinds that we're going to have, the ones that we know that are coming around the corner in a couple of years and the ones that are unknown. So the way I've approached this in the past and approach working with the physician leaders, it's really, really important to engage our physicians and physician leaders in part of this solution which is then looking at service line models and how do we deliver care within a service line enterprise model, do we create efficiencies through there and order sets and standardization of order sets that all physicians agree within a subspecialty is going to be really, really important. And then looking at models of care, what are the venues in which we play. So it's important to optimize that portf and continue to drive margin through that optimization. Another aspect that people forget on the financial equation is really the clinical burnout rate. So if we can find ways to reduce the clinical burnout for our clinicians that enables them to continue to want to operate at their peak performance. So that's something that's going to be really important. Digital doorstep and integration is going to be really, really important. Creating an Omni Channel experience for our consumers to access care at Atlantic Health is a way to create patient loyalty and consumer loyalty. And if we can do those things in a way that consumers feel valued and feel like they're hurt and seen as a whole person, I think that's going to be a way to succeed in the future. In my opinion that makes a lot.
- [14:53]
B
Of sense and thank you so much for going through that. It seems so simple, yet I know in practice much more complex. I appreciate your thoughts here looking ahead as well. Where are some of the big opportunities for growth that you see in the next few years? In spaces where you really can make a difference.
- [15:13]
A
No crystal ball here, but we all know the environment that we are operating in is very dynamic and is going to continue, continue to be dynamic. So I'm going to double down on. Organizations that leverage internal talent are those who will thrive in the future. Our workforce is going to be critically important and part of that is creating a curious workforce. A curious workforce is one that is always looking at things to look at it, doing it differently, which feeds innovation. So that's very important. Another thing that's important in that internal talent is creating psychological safety for our team members to experiment and fail if they fail, fail fast, learn from it, pivot and then adapt and grow so we can create that psychological safety for risk taking to take place. Organizations will continue to do well that harness that psychological safety aspect. And it's my belief that every three year cycle organizations will need to disrupt themselves and iterate across cross collaborative care delivery models in order to succeed. Because the environment is going to continue to pressure us from inside the industry and entrance from outside the industry as well. This is easy to say, but in practice it's much more difficult is remove silos and create a frictionless system that are directly connected to consumer convenience. We've got to focus on consumer convenience and then get complexity of accessing care out of the way so patients can access us in a way that is easy for them. You're going to, you're going to win that war against any competition out there because you're able to take care of the patients in the manner they want to be taken care of. At the time they want to be taken care of and at the right place, right venue and at the right cost.
- [17:10]
B
That makes a lot of sense and, you know, really ties nicely into the overall strategy when you're looking at workforce, when you're looking at what can make a big difference for the overall growth of the organization, reputation and more. It seems like it really starts with the team there, which, you know, is a great way to approach leadership, especially during these uncertain times. Now, before we wrap up here, I'm curious, what from your perspective do you think will take to lead an organization and make sure it thrives in the next five years or so? Again, I know no crystal ball, but I can imagine some of these principles are stabilizing force through some of these challenges.
- [17:48]
A
All right, you're absolutely right. Workforce stabilization is important. I think it's important to focus on population health and growth of the value based care aspect portfolio of the organization. At this point we have about 38% off our patient population is on a value based contract, risk based contract. That's something that's important for me to continue to grow and get to the 50% and get off the fee for service training, so to speak. And then it's going to be really important to look at your portfolio, what's your portfolio, and then optimize that and position it for, for future growth as well. And then you cannot ignore the quality and safety outcomes because that's your brand promise. You've got to deliver on patient safety and quality outcomes and also on patient experience. So we're going to continue to double down on that. And as I mentioned before, succession planning, because your workforce is your greatest asset on any balance sheet, doesn't show up, but it does show up. When there is attrition in your leadership and you don't have a backfill strategy, those organizations then continue to have a lull till they are backfilling that person. And then it really takes key leaders to be replaced. It takes about a year, 18 months for them to get caught up on the culture of the new organization they're entering. So it's important to retain the talent that we have so we can continue to thrive without missing a beat.
- [19:16]
B
Fascinating. Saad, thank you so much for joining us on the podcast today. This has been such an enlightening conversation and I appreciate your time. I look forward to connecting with you again soon.
- [19:26]
A
Laura, it was a pleasure. Thank you for inviting me.