Phoenix Children’s is making a concerted effort to empower its clinical leaders to provide exceptional care by creating a culture that encourages collaboration, transparency and innovation.
In this new podcast, Dr. Jared Muenzer, chief physician executive at Phoenix Children’s, shares the strategy behind building strong clinical teams and the positive impact it's having on patients.
Healthcare Insider Podcast: Empowering clinical teams to deliver exceptional care
Maria Castellucci:
Hello and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Maria Castellucci, Deputy Editor of Custom Content at Modern Healthcare. It's my pleasure to welcome to the podcast Dr. Jared Muenzer, Chief Physician Executive of Phoenix Children's, one of the nation's largest pediatric health systems. In his role, Dr. Munzer leads clinical care, behavioral health, the Phoenix Children's Care Network, clinical research and medical education. He also has oversight of Phoenix Children's Pediatrics, the health system's growing network of pediatric practices throughout Arizona. Thanks so much for being here, Dr. Munzer. I'm really looking forward to our conversation.
Jared Muenzer:
Thanks, Maria. Thanks for having me and thanks for those kind words.
Maria Castellucci:
Of course, so let's dive right in. So, Phoenix Children's has been growing rapidly and has seen great expansion, including the opening of a second hospital this year and a third hospital opening next year. So as chief physician executive, how are you ensuring the clinical services keep pace with all of this expansion?
Jared Muenzer:
Yeah, great question Maria. You know, we've been on a 10-year journey of growth and I really think what has been really beneficial is we really have had a 10 year strategic plan that has allowed us to get through this process of growth and really prepare ourselves to be ready. You know, with your question of how do we make sure the clinical services are keeping pace, it really started back, I started in 2016 with our strategy and that strategy really started with how do we grow the physician practice, the provider practice, our nurse practitioners, our physician assistants, and how do we do that? And back then, in 2016, 2017, 2018, we were really a mixed model of employed and sort of contracted or private practice subspecialists that worked at this institution. And so we really spent the last eight years moving to a more of an employment model. And so we brought on numerous different divisions to employment. And that was a lot of our surgical subspecialists, anesthesia, neonatology, infectious disease, nephrology, and really sort of grew us from about 26 pediatric divisions to 38 divisions. And that really was the strategic thing that put us in a great position for our growth, because then we had control of that. And so we sort of leapfrogged off of that, and began thinking about, as we're gonna open these new facilities, how are we gonna service the patients and our families so that they saw all of our services at as many locations as possible? And so that really led to that. And so that really combined with other strategic initiatives, growing our fellowships, working on workforce development across numerous different platforms in nursing and mental health. And again, to growing the residency, growing the different kinds of fellowships that we have. That really put us in a great place to be able to build the numbers that we would need. And then over the last eight years, and I know we're gonna talk a little bit more about this in this podcast, really started thinking about what's the best leadership structure for the organization to allow our leaders to be empowered to deliver the clinical services in a world class way. And so that's what we started to do was say, how do we empower you to do that?
Maria Castellucci:
Yeah, I'm excited to dive more into all of this with you. The fact that Phoenix and Arizona is a growing population, has that helped with the recruitment of physicians and clinical staff?
Jared Muenzer:
Absolutely, I think there's numerous factors of Phoenix that have really helped us and you nailed the biggest one and that's just massive growth, right? We're seeing families move to this area, we're seeing lots and lots of industry move to this area and all of those things help, right? We hire providers who have spouses who need jobs, right? And that's not always in healthcare and so that helps us and we see you know, with our size, we also see a lot of this growth where we see professionals leave for some of their training, but because they're connected to us in some way, they want to come back. And so all of those things have really had a positive influence on us hiring the staff that we need and the professionals that we need.
Maria Castellucci:
Great, okay, so what tools or innovations are you deploying to help the clinical teams be more effective and efficient?
Jared Muenzer:
Yeah, so I think a lot of things that we have done, I think one of the biggest things is we have really harnessed data. I think one of the things that our leaders need in order to implement the most efficient operational pathways to get patients access, right, that's what we're chasing, right, patient access, patient access. And so we really worked on systems utilizing data. One, to provide data in a routine monthly basis to our leaders to understand where their holes are, where their opportunities are. And that data includes everything from how do you fill your clinic and what's the wait time and all of that data that we talk about in clinical medicine. But then we started going steps further. We started really incorporating dashboards. We started incorporating real-time data to follow things. And now we've even moved into the predictive analytics stage and building these programs. And I think I can give one great example. And one example is, we actually monitor all of our in-patients in the hospital for malnutrition. And this system is in the background operating at all times. And it literally identifies kids that look like they may have malnutrition and has a nutrition consult placed so the nutritionist can go in and evaluate if there really is malnutrition. And we've had extreme success rates with that in identifying kids who needed that help to get out of a malnutrition state.
Maria Castellucci:
That's really cool. It sounds like it could also be touching on the social determinants of health as well, right?
Jared Muenzer:
Yeah, and that's a whole other area where we have gone, we've really grown and matured in. We made, really bought in about a year ago, maybe a year and a half ago to Social Determinants of Health, and now screen all of our patients across the institution, no matter where they're touching our facilities, every six months. And so not only that, we now have, we're not only taking that data, we actually have care coordinators monitoring that data to assure that our families are connected to the resources they need at the state level. And so that allows us to assure that not only, hey, we've identified that you need housing, we've identified that you don't have enough food in house or that you can't pay your electricity bill, all of those social determinants of health that truly impact physical health. And we've basically made sure that we are closing the loop on it. And one of the things that I'm most proud of as an example is, we have a lot of social determinants of health that patients that have identified nutrition as their issue. And so we actually partnered with a mobile food pantry who comes onto our campus with their mobile food pantry. We chose because of data for that to be on Tuesdays because that's when the most number of patients we see in our clinics and those families are notified electronically and we've used philanthropy to give all of them a $10 gift card to that mobile unit, and they can feed their family for a week with that $10. And so these are the things where you start connecting the technology with what we really want to be as an institution and the services that we want to deliver.
Maria Castellucci:
Yeah, that's very, very cool, very inspiring. I wanna go back to the workforce and the clinical team. So I understand that you put the division chiefs and the leaders of the Phoenix Children's Medical Group through a business masterclass, which is really interesting and not something that I've heard before. So can you tell me what was behind that decision and how it has made an impact on the health system?
Jared Muenzer:
Yeah, I think back in 2016 to 19 when I sort of first took over as the chief operating officer before I became the chief physician executive, really understanding that the most important relationship to drive world-class care in our divisions was the relationship between a division chief and their administrative partner. They were the ones that together harnessed the knowledge to say, in pediatric gastroenterology, this is what we need to do to service the community and our patient population. And what I realized is that each side of that coin, the clinical leadership side and the administrative leadership side, you can't expect them to know everything, right? You can't expect them know all of finance, to know all of clinical care, to know all of operations. But by providing each side of that coin with enough information and education around those key components that that would make us stronger and better together. And so we sat out with our division chiefs and said, what sorts of things do we want them to learn in didactics? What sorts of things do we want them to learn on the job? And we built a program that we sent our division chiefs through in two cohorts over nine months each. And we included all the things I talked about. We had our finance people come in and talk about finance and how they look at finance and the important data points in finance. We had operations leader come in and talk about the data that they look at. And we also included some of the other soft leadership skills. How do you have a difficult conversation? How do you manage through an employee who's struggling, whether that's emotionally or professionally? And we sort of included all of that. And most importantly, I think, when we did this, we did it as a group. And every single time they met, we did group exercises. one, think one of the greatest things we got out of it was you would watch these division chiefs at a round table and they would all be talking about how they handle different problems. And it helped the division chiefs see, look, I'm not on an island. I'm not by myself. I not only have my administrative partner, I've got 37 other division chiefs, many of which have tackled some of these problems. And we just started seeing this economies of scale grow. The last thing I will add, Maria, that was really impactful was, and I give my operational team a lot of credit, was we dove in to make sure everybody had the data that they needed and that it was accurate. Because I will tell you, clinical leaders will push and push and push for accurate data. And they did. And we deliver that to them now.
Maria Castellucci:
Can you talk a little bit or do you have an example to share of what the impact has been since this training?
Jared Muenzer:
Yeah, absolutely. I think I'll take one example, gastroenterology. I recruited Dr. Ashish Patel, who has now actually been promoted to be the physician in chief. Some of this because of his success buying into all of these things. But we knew that we had to evolve our gastroenterology service line to really grow and fill all the needs of the care continuum in gastroenterology. And what I mean by that is, you have to talk about inflammatory bowel disease. You have to talk about constipation. You've got to talk about how people with feeding disorders or kids with feeding disorders and how you, there's all of these things that make up the full complement of a GI program. And we were missing some of those things. And we were missing some of those things in part because of what I talked about is that our clinical leader and our administrative leader weren't necessarily on the same page to say how do we build out all of these component parts? Now we may have had a little bit in all of them, but we didn't understand the full book of business. And I give Dr. Patel a ton of credit along with his administrative partner, which was originally Stephanie Nelson, which is now Angie Lingenfelter. And they got together and they said, okay, how do we fill these holes and how do we build the case for each of these programs to go out and recruit and invest the money. And then they bring that to me and their partnership made that case easy. It was easy to bring that to me, to the senior leadership, to Bob Meyer, the CEO and say, this is what we need to do to have a full. And what we've done over the last five years is we have every component in that GI gastroenterology care continuum filled. And it's been hugely successful.
Maria Castellucci:
Yeah, it's really fascinating to hear all the different components that have to come together to make these complex programs and all the pieces that you need to have in place from a leadership perspective and a collaboration perspective. So, thank you so much for sharing that. I think it's going to be really helpful for our audience as they're thinking through how to grow these programs. So back to the workforce, we talk a lot about the multi-generational workforce. So are you using different strategies for the different generations to make sure they understand what's going on at the system? How are they making sure they have a voice in decision-making and sharing feedback?
Jared Muenzer:
Yeah, I think absolutely. One, I think what I've learned in this role with the leaders and assuring that, back to what we talked about, Maria, right? The communication stream can't only be with the clinical leaders and the providers. It's also gotta be with the administrative side and it's gotta be, they have to both see it and understand how to react to it. And I will say, I've grown and I've probably had some, I won't necessarily call them mistakes. I'll call them opportunities to improve along the way. And what I've learned is you nailed it with the multigenerational. I truly believe that you have to find every medium you can to communicate and to communicate effectively. And not only that, I think it's not just how things communicate out from administration. How do we get it back? And how do we build those, I'll call them communication highways, so that the information is going both to the providers, but then you're getting it back to you. And I think we really have done a lot in that domain. Clearly, there's the standard emails, there's the standard meetings, those sorts of things. But we've added other things. I have connections between multiple committees that assure that the directors and managers on the administrative side, when they have their monthly meeting, the agenda items overlap almost know, 50 % of the time with what I'm doing in a division chief meeting so that they're hearing exactly the same thing. I've added things like office hours. So monthly I do office hours with the senior physician executives and it's, we do it either at 7 a.m. or 5 p.m. We alternate because not everybody can be there at morning or night. And any physician, any provider, APP, can come to that and ask any question they want. And it's really great to see that have economies of scale because every single time we have a conversation there, that makes the people that come and hear the answer, they become my vehicle, right? They're going out and sharing what they learned. And so I think that's how we've matured in terms of the multi-generational.
Maria Castellucci:
And I think one point you made is also important. They can ask any question they want. So it sounds like transparency is also really important. Can you speak to that at all?
Jared Muenzer:
Yeah, absolutely. And I think that is something that I learned very early on when I took on this role was that you had to find a way to bring everybody to the table and give them all of that transparent data, because it was unfair if they weren't hearing it. And I think I'm a big fan of no but in the sense of when you can't do something because a lack of resources are not the right time, you can't just say no, you have to say no and why. Or no at this moment, but if you can do this, this, and this, or add this, this, and this, then we can have another conversation. And I think that transparency of explaining is very, important to the success of this medical group. And back to what we talked about earlier with the masterclass, right? Helping our directors and our division chiefs, our clinical leaders be able to learn that skill as well. So when a provider is asking them for something, it's not just no, or it's not just no administration says no, it's these are the reasons why, and this is when and why we can reconsider it.
Maria Castellucci:
Yeah, and you can imagine all the impact that has on retention and the culture that you're having a transparent conversation about why.
Jared Muenzer:
Absolutely.
Maria Castellucci:
Okay, well this has been fantastic. Thank you so much for your time, Dr. Munzer. It was so nice speaking with you.
Jared Muenzer:
Yeah, absolutely. Thanks, Maria. It was fantastic.