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Becker’s Healthcare Podcast
Trampas Hutches, MHA, Regional President of the Mountain Region at MaineHealth
00:18:01
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- [00:01]
A
This is Laura Dardo with the Beckers Healthcare podcast. I'm thrilled today to be joined by Trampus Hutches, who is the regional president of the Mountain region at Maine Health. Trampus, it's a pleasure to have you on the podcast today.
- [00:13]
B
Thank you for the invitation. I look forward to today.
- [00:16]
A
Absolutely. Now I'm excited for our discussion because I know there's so much happening in healthcare right now and it'll be particularly interesting to dig a little bit deeper into some of the cool things you've been doing at MaineHealth as well as getting your perspective on the future. But before we dive in, I'm wondering, can you introduce yourself, tell us a little bit more about Maine health. What's your biggest winter success story from the last year?
- [00:37]
B
Yeah. Thank you, Laura. So I'm the, as I mentioned, the Mountain region president for Maine Health. And so Maine Health is New England's northern, New England's largest integrated healthcare system. We span for most of the state of Maine and also New Hampshire. We have about 12 hospitals, about 25,000 care team members. My flagship academic medical center, main medical center which is a ninth intermediate hospital and then we also have a large behavioral health hospital in Spring Barber. And so we have all the normal things we'd expect the health system have. But I really appreciate working for Main Health. That's where we really do live our vision of working together. So I think that help you in America. And so my particular region, I serve all of western Maine which is the more mountainous region and then also I serve all of the state of New Hampshire. Our catchment area is about rated about 450,000 people. And it's also the more rural area in Maine Hill, which in Maine, in New Hampshire is some of the most rural states in the nation. So really the focus of what I do at rural healthcare, but also urban areas health cares, I also take care of other things such as our newly formed post acute care division and also our three year old main health EMS which is about 300 paramedics strong. And so I would say our biggest wins for the past year is a couple of things. Actually as I mentioned, our post acute care division, we just did that up really working through integrating all of our post acute care assets and entities and relationships that we can continue to really focus on a long length of stay challenges we're seeing not just in the medical center but across our health system. So that's had a lot of great impact so far beginning the first year with that. And then also recently we've changed our governance model to reflect our operating model, which I'll get into in a second. In our governance model, we have multiple different community hospital boards and we move to regional boards which have three regions of main premium billboards and then also the main health board just have the overall fiduciary responsibility of the entire health system. But I have to say that our biggest win in the last year is really we're in our third year of our new operating model. We moved into regions as we became unified, fully unified as a health system. In 2019, we integrated all of that into regions and we put a lot of focus on integration as it relates to the work, how work gets done, utilizing a balance, work hard, cascading our strategic plan all the way down to the front line. And we can see a really good improvement in all of those activities. Our strategic plan in my region particularly, we're having high degree of quality outcomes, our patient experience is extremely high, we just got our care team engagement results in prestige and my region is performing extremely well. And then from a financial perspective, we're really bucking a trend in my region for rural healthcare. We have consistently 8 to 10% operating margin. A lot of great work has gone into having a high, reliable, high performing organization. In particular, my region kind of say the culmination of all those things in the past three years of working towards all of those things is really, I would say, the highlight in the past year.
- [04:22]
A
Well, that's amazing to hear and certainly impressive to have the 8 to 10 operating margin, especially given the challenges that we've been through in the last few years in many organizations are still facing. So from your perspective, you know, when you look at the success and looking at especially being in more of a rural healthcare setting, what do you see as being the difference made actually achieving that high, reliable, high performing organization? I know a lot of hospitals and systems go after that, but not a lot see that those same results. And so I'm curious, what do you see as being the difference maker for you?
- [04:54]
B
So what we've really done is really become extremely laser focused on processes, integration and process of looking at things from how our workforce is performing, ingots, benchmarks, putting processes in place. To look at our contract labor spend in my region, we reduced contract labor spend quite a bit. In fact, out of about 3,000 employees in my region, we only have 14 contract labor contracts at the moment. And so put a lot of focus on not just moving those contracts to full time employees, really focusing on engagement, culture, all those things and how we've done that one of the ways we've done that is through a really rigorous approach to our leadership development program that we started being called a couple of years ago. Part of our strategic plane health is that all directors and above will have a individual development plan that really hinges on our philosophy of growth mindset. And so in the past couple of years, we're really focused on delivering and focusing on developing our leaders from that aspect. And so in my region, we've done a tremendous job. And in fact, 100% of our leader, director and above have that training. And so you can see that leadership development really take in effect that the can do attitude, the focus on continuous improvement, all of the right things has really been the focus on that. But also I would have to say that we're fortunate to have a great recruitment team just for our care team, but also our providers. We've had a lot of success in the provider recruitment, so we're able to fill those positions as they come up. But also our turnover has been going down dramatically because we've just been focusing on the culture side of things for quite some time, but also looking at ways we integrate across the system from a horizontal perspective and making sure that we're reducing as much overhead to expand subject hand as possible. And then everybody understands the direction we're heading. Our CEO, Andy Muller, joined us. How do we deliver on our vision of working together? And we really think that seriously as we work together from our region, but also with some of our partners and our competitors, also knowing that we can do everything. But how do we utilize and leverage those partnerships where.
- [07:29]
A
That makes a lot of sense. You know, it seems like a really great way to move forward with some practical as well as cultural items that, you know, are just fascinating to hear about. So amazing. Thank you so much for digging a little bit deeper there. Now, what's really top of mind for you right now? What are you focused on and what issues are kind of constantly at the forefront?
- [07:51]
B
Yeah, so the biggest one is workforce redesign. Really thinking about strategically and intentionally. When we have opportunity in our workforce, does it make sense to continue to done what we're doing, or is there some other opportunity that exists? For example, we had a couple of leadership positions come up at a transition act organization for multiple different reasons, career transits, et cetera. And instead of just replacing the leadership positions in the region, we said, you know what, why can't we, from an imaging perspective, be multiple sites, fund department leaders and those kinds of things? And really looking at that, and also the really great thing that happened when you start integrating like that, taking a look at all of our capital equipment and imaging, which is a tremendous amount of capital spend, and have as far as capital goes, streamlining the ways we use the clinical pathways and then also making sure that we're moving all that clear variation across the board so that the care we deliver is highly reliable. So that's one way that we've done that. And also I'm just really focused on throughput. We know we still have a lot of work to do around throughput, particularly in our academic medical center. And we have a long length of staying patient situation that we need to solve for. And that's where we developed the new post acute care division to really look at how do we make that blueprint better by looking at the way we care in the post acute environment, make sure that there's continuous roof of opportunities for our patients rather than being at the hospital where they just don't. It's not a good setting for them when they don't want to leave that acute care. And then also really focusing on the trust of our care team in our communities. Also, healthcare has become more expensive, as we know that, and looking at ways we can reduce total cost of care and our different ways that we deliver our care, but also really focus our community making sure they're understanding what we're doing, why we're doing that, and then also our care team as well, making sure they're understanding what we're doing and how we're doing that, and being transparent with all those things of some of our, at least my top three areas under the period that we're focusing on.
- [10:09]
A
As a whole system, that makes a lot of sense. You know, it is really fascinating to see that evolution of how the workforce has evolved in a variety of ways. And it's cool to hear from you how you're doing some of those upskillings and continuing to integrate everyone together. And then too, you know, having the transparency, being able to, you know, impart that message to the community of everything that you're doing to try to elevate the level of care, reduce cost and figure out the best and most efficient way to deliver care to the community. I'm curious, when you look ahead to the future, what do you see as some of the big opportunities for growth and development?
- [10:52]
B
Right. I mean, I think the big one everybody's talking about right now is AI, right? AI and automation. And so, yeah, we're really working through that just like everybody else is. And so we've already implemented a lot of things and going back to that culture aspect of things is really looking at how do we remove administrative tasks from our physician and ATP staff so they can just do what's important to them and take care of the patients. A lot of organizations have already done it, so it's nothing big but a bridge of AI documentation tool that our physician APUs and the results we've seen is dramatic and dramatic improvement in their workflow, their livery, their lives, burnout, all of those things. And so I had a very cynical physician come up to me a couple of weeks ago that was cynical on a bridge itself and just overall the state of healthcare and they said that the single best thing that's happened to that, excuse me, in the last 20 years, is a bridge and ability for it to do a lot of the work that they didn't feel value added. And in fact now they mentioned that now they have opportunity to add two to three more patients per day and really improving access just by the change in use of AI bridge. But we're not just using it just for that also, but looking at we are using it for our revenue cycle, our denials, our preauthorizations, all of those things. I kind of joke to some of my folks and my staff and say, you know, it's just like this battle bot world war between payer AI and our health system AI going at it in cyberspace trying to get a pre op done, which is a whole another discussion for another time. But we're meeting that need and that demand. People are using AI as we know pre authorization is increasing and then also just really looking at strategic market expansion where it makes sense. And so rather than doing everything, we're really focused on those items that we feel that make sense in the community needs and also not just in a way of going in and doing it, but requiring at least in my region in the way we do it. We're requiring at least 50% of all activities that we do and expansion activities be either with a new care model or using payment models that are different than we do today. And then also really looking at new models like everybody else is really looking at virtual at home and really moving to the ambulatory focus area and staying away from that bricks and mortar. And if we added the bricks and mortar solution and making sure that we have those virtual options and all of those things looking for what we do.
- [13:47]
A
That's fascinating to hear and truly amazing to think about what technology has been able to accomplish in easing some of the clinical burdens, as you mentioned, as well as you know, how virtual care is becoming more possible and so many organizations are figuring out ways that they can truly improve the patient experience, improving access and more. So I really appreciate kind of your focus there and seeing that as a huge opportunity to continue growth. Now, before we wrap up here, I'm curious, what do you think it will take in order for healthcare leaders to really lead thriving organizations in the next five years? Especially given some of this transformation we're talking about with artificial intelligence technology, how healthcare is really moving into other settings besides the four walls of the hospital. What does that look like for you?
- [14:36]
B
Yeah, I think the next five years along the leaders have really rethink everything, question everything and help everybody understand that there are different ways of doing things and then also build trust while we do that. And so I think that's going to be very key in how we do that. Really bold, transparent leadership, that's what it's going to take. And so, and going back to that leadership development process, really making sure all of our leaders have that growth, mindset and ability to continuously improve, I think it's something that's going to be very key for all of us. One thing I did forget to mention is actually we use Press Gaining's Care Team Engagement Survey. We just recently got a result. Our leadership index is actually pretty high, about a 4.3 on a 5 point scale. So we see that from a measurement perspective that is actually working and seeing those results so continuously to work on that development. So we really need the leaders to help the culture evolve and be resilient and develop as we go along over the next five years. And then also it's going to require a lot more rigor around efficiencies, looking for areas in which we can integrate, remove care, variation, reduction, all of the things that we're doing right now, but be more rigorous around that. And then also it's going to require a lot of clarity on the things that we're doing and making sure everybody understands the headwinds we have in front of us. Like in Maine, where the oldest state by median age in the nation, we're already planning for the next five to seven years. What's the care going to look like? How are we going to deliver it? Making sure that everybody understands this has to be different because A, we're not going to have enough staff to deliver that kind of care. We have to do things different. But also not just the next five to seven years, but in the next 15 years, it's going to look different from there because then we know the baby boomers will be aging out of population, so to speak. So looking at just the future of health care and how do we develop a culture that we're able to be nimble and accept these changes in areas where they're pretty entrenched and culturally norms, so making sure we have that ability to get them out of there and then also just the courage do the right thing at all times and then the execution of the strategy and the direction of the organization and seeing.
- [17:02]
A
That'S fantastic to hear and really inspiring words. Trampus, thank you so much for joining us on the podcast today. This has been a really fun conversation and I look forward to connecting with you again soon and seeing you at our CEO CFO Roundtable as well this November. I think it'll be a great opportunity to connect with so many different leaders and continue this conversation in a really meaningful way.
- [17:22]
B
I really appreciate it and I'm really looking forward to the Roundtable this fall. And I'm also just most excited about continuing what I'm doing and leading the teams that I lead. But I'm very fortunate to lead and really just take on the challenges and making sure that we can have a healthcare system that really takes care of our features. I appreciate the time to take.