The Healthcare Leadership Experience

Storage in healthcare is often seen as a low priority. Brad Fitzpatrick of FitzRight Storage Solutions explains why it plays a critical role for hospitals to Jim Cagliostro. Episode Introduction Brad explains why he is potentially in the business of ‘’life and death,’’ how Covid changed the storage landscape and the opposing views of storage as luxury versus necessity. He also highlights the positive impact of storage on hospital margins, and shares why success in business comes from a focus on customers and ‘’attracting’’, not chasing. Show Topics Two common storage pitfalls The impact of Covid-19 Storage is ‘’potentially life and death’’ Convincing the C-Suite Transforming relationships: A storage success story Leadership tip: Focus on your passion 04:15 Two common storage pitfalls Brad explained why hospitals push storage down the list of priorities. ‘’I would say probably the number one would just be the misconception that optimizing your storage is more of a luxury than a necessity. And everybody has different reasons for not moving forward, or for lack of a better word, neglecting. Whether it be, "Well, we intend on doing that one day." Or, "It's out of the budget." Those two are usually the biggest ones. But the one day is a slippery slope because you don't want to wait until you have a fire till you get the sprinklers installed. ‘One day we’ll do it.’ ‘’ 05:50 The impact of Covid-19 Brad said the storage landscape changed a lot after the pandemic. ‘’I'm sure this applies to everything, and it won't surprise you when I say it, but Covid. Once Covid happened, and the pressure came on unexpectedly, I think everybody was able to assess how prepared or unprepared they were when the chips were down. And then, once that dust settled, there were some hospitals that said, "Okay, we never want to be caught off guard like that again. What areas can we fix? How can we fix it?" But then, there were other facilities that said, "We'll wait until the wheels fall off." And, actually, there is one hospital I spoke to recently, and they were told that, "Well, wait until the wheels literally fall off and then we'll redo the room." 11:25 Storage is ‘’potentially life and death’’ Brad said access to supplies and equipment can improve patient outcomes. ‘’Yeah, I don't think it would surprise you that, first and foremost, I think it impacts patients with reduced delays. We're in the business of potentially being life and death. So quick access to supplies and equipment, it minimizes any treatment delays, and that also improves patient outcomes. That said, also, I think the professional environment, a well-oiled machine doesn't work as well if the gears aren't where they should be. A well-organized hospital creates more of a professional and a reassuring environment which, for their patients and their families, can really go a long way. But hospitals aren't exclusive. A library runs a lot better when it's organized. A restaurant, a law firm, everything works better when things are where they should be and there's no surprises.’’ 15:09 Convincing the C-Suite Brad explained the advantages for leadership in recognizing the value of storage. ‘’I don't really see myself as the type of salesman who's really trying to convince anymore. I'm more of attract, don't chase. But that said, when I come in, I can read the room. I know when I'm here to give a bandaid, and then I know when I'm here to give open heart surgery. But that said, there's an increasing number of individuals who see the value in storage after years of working with me. And some of the best projects I have are when these individuals, they get relocated to a new facility with a higher role. And then they have a whole clear canvas that they're able to paint and make their own baby and really create. And I don't think it's a coincidence that the individuals who prioritize organization and storage are the ones who are finding themselves getting...

Success in every industry is about effective leadership. Business coach and author Steve Lover explains how every organization can inspire world-class performance to Jim Cagliostro. Episode Introduction Steve explains why confidence is the #1 priority for every employee, outlines the five keys to effective hiring and the three factors to fuel world-class performance and explains why customer service is dead. He also outlines why motivation doesn’t work, why organizations need to get messaging out of the marketing department and why everything happens on the other side of fear. Show Topics Defining ‘’world-class’’ Five keys to effective hiring 3 ways to ignite world-class performance Fear and courage aren’t opposites ‘’Customer service is dead’’ Messaging needs to come from something real Leadership tip: step into the fear 07:07 Defining ‘’world-class’’ Steve explained why success in every industry is all about leadership. ‘’I like to say, and this is really, I've said that I say this in two different places in my book, but it's really interesting speaking to a medical group of people. When you walk into a doctor's office, sometimes you'll walk in, and the staff is pleasant and they're nice and they're welcoming and they're caring. And you walk into another office, and you feel like they're doing you the biggest favor by just showing up to work in the morning. Very often they're sour faced, sometimes they're even nasty. Well, I believe that that comes from the doctor. A doctor that really cares how his patients are treated, that's the first office you went to. A doctor that's really worried about what the money in the business is looking or other things or efficiencies. That's the second business. So people have to be, they're going to follow you and how you lead them. And what Willink came out in his book was in the good leader over there, everybody had extreme ownership of what they were doing. And the other one, they didn't. And so really, you had mentioned something earlier, what world-class is. And to me, the definition of world-class is when you decide you want to do something, and you can fulfill it. So we say we want to get this done as a company. The fact that we can get that done based on what we said we wanted is what world-class is about. And when it comes to having people work for you and getting them on the program and then getting them involved and getting them excited, it's a whole different ballpark on how you're going to have those discussions.’’ 12:12 Five keys to effective hiring Steve outlined what every employer needs to look for in a new hire. ‘’I believe there's five things that you need in a good employee, and they're not the five things most people look for. The first one is, do they have an aptitude for the business? Now, you might have a business that needs a certain amount of skill that they've learned, but experience is never what it's at because very often you have to unteach them. And so do they have the aptitude? Do they have the ability to do this work? Is this work a good job for them? Number two, the most important of the five is, do they have the right attitude? Are they people that are going to be upbeat, optimistic, go, and with a gusto to the business? The third one, the hardest one to find is, do they have a good work ethic? Most people today do not have a good work ethic. And so finding people that have a good work ethic or would like to develop it, as a third one, that's the hardest one to find. The next one would be, are they coachable? Is this somebody that you're going to be able to have a real discussion, help them get better? And they're going to be willing to take that discussion. If they're not coachable, it's a mistake. And then finally, are they a good fit for your culture? If they're not a good fit for the culture, that's going to create waves. …. And if those five things are in place, I believe you can overcome almost anything.’’ 14:57 3 ways...

Higher education plays a vital role in preparing and developing healthcare leaders. Dr Giuseppina Pagnotta explains why to Jim Cagliostro. Episode Introduction Giuseppina shares her inspiration for going back to her doctorate during Covid, the importance of giving back to the world and how higher education can support career aspirations in nursing and healthcare. She also explains the role of connection, and why time is one of the most precious gifts leaders can offer. Show Topics Higher education can open doors Paying it forward: sharing your knowledge Offering inspiration and guidance through mentoring Self-regulation and building connection Leadership tip: Giving the gift of time 04:00 Higher education can open doors Giuseppina encouraged people to understand how further education can support your career aspirations. ‘’And I tell people now, young people or anyone that's getting their nursing degree, whether it be from an associate or a baccalaureate program, to go on for the MSN. It's really important in today's world to get that advanced degree because you can keep it in your back pocket, and then it will allow you to have doors opened for different opportunities in your facility or in education or even as an entrepreneur. There are so many nurse entrepreneurs out now. So I attained my MSN in 2020, and our graduation was outside because of COVID, so we ended up having the graduation outside in August of 2020. And then, during that COVID spring, I realized, "What will I do with the MSN? Will it get me where I want to go?" So on that note, I evaluated, "What would I do with it? What doors will it open?" You always have to consistently evaluate, and I even tell my children, "What doors will your degree open? Where will jobs proliferate? Where can you get employment? What do you want to do with that degree, and what is the propensity of getting a job?" So then, you have to evaluate what employment opportunities does that degree align with.’’ 08:44 Paying it forward: sharing your knowledge Dr Pagnotta explained why sharing skills and knowledge can help others. ‘’I think that if you have a skill, knowledge, skill, abilities, whatever you have, and I don't want to keep them for myself. I am on this earth for this many years and if I can share my knowledge and share my path with you, then you can take it forward and go take it somewhere. I realized in the past few months that it's not about me. It's about what tools I can give to you and what tools you could run with. And I don't even have to hear from you ever again as a teacher-student, but just to know that I impart with you with the skills to learn and to grow and to get excited about learning, that's enough for me. And also, with recent times and my recent role in the Monmouth County School Nurses Association, I realized that I'm giving my leadership skills to others, and I'm teaching them school nursing leadership and nursing leadership, and they're rolling with it. It makes me so happy to see others flourish with the skills that I'm giving them and the excitement and fostering that relationship and creating an excitement in them in the role in nursing leadership. 14:06 Offering inspiration and guidance through mentoring Giuseppina said it’s important for leaders to examine their motivation behind mentoring. ‘’I think it's dual fold. It takes a lot of work, but yet it's so rewarding. For myself, I started out as an American Nurses Association mentor. I think it was two years ago, and I was matched with a mentee across the U.S., and we would meet, I think, once every two months for 15 minutes and talk and then give each other... I would give strategies as to what her aspirations were or their aspirations, and we would continue the conversation there. It was interesting because I tend to want to inspire you. I want to inspire you in your path, and I want to look up possibilities for you. If you want to go back to college, I will look up...

Language can have a powerful impact on the patient experience and our perspectives on illness. Claudia Cometa, author, pharmacist, and founder at Peace Advocacy Group explains why to Jim Cagliostro. Episode Introduction Claudia explains how her passion for advocacy arose following her father’s illness, and how moving away from images of a cancer ‘’battle’’ helps us to see our bodies as allies, rather than adversaries. She also highlights the barrier to healing created by the language of competition, how she found inspiration from the Princess of Wales, and why no patient should feel like they are a burden. Show Topics ‘’How is this the patient experience?’’ Seeing our bodies as allies, not adversaries Moving away from an ‘’illness identity’’ Overcoming the language of competition Creating a more peaceful patient experience Leadership tip: Twofold knowing 02:44 ‘’How is this the patient experience?’’ Claudia said it was her father’s cancer diagnosis that prompted a heart-centered decision towards advocacy. ‘’…my father was diagnosed with cancer in 2016, and I quickly was in crisis resolution mode. I was on the other side of the equation, jumped headfirst into that side as it just made sense. I was the only one in my family who was medically trained. And so I saw the other side of the system for the first time of any significance and was mortified like, "How is this the patient experience? How did I, number one, not know this was the patient experience and how am I just now coming to grips with what is happening on the other side of where I'm working?" And it was very discouraging. Obviously helping my father, you want the best care for your loved ones. And so to not be able to get that, to be dismissed, I ended up firing several hospital systems. It was a really, really negative experience. And that was with my oversight. That was with my deep understanding of the medical system, how to navigate it. …. And so I vowed at that point that I have to do for others what I did for him. There's just no other way around it. …. It was a feeling that I've never felt before. It was a heart-centered decision-making I had never done before…’’ 06:32 Seeing our bodies as allies not adversaries Claudia said using ‘’battle’’ language around cancer makes it sound like our bodies are the enemy. ‘’… if I go back to when I was helping my dad, I hadn't really come to this realization yet. And so I was the daughter who was posting on social media, "We're going to fight this, cancer chose the wrong girl." I just fell into the trap of what sounded like what I'm supposed to say. Like, "Yeah, I'm going to win this battle." And it wasn't until years later, well beyond when he passed away that I really started to question, some of this being part of my spiritual growth too and personal development, but how are those words really helping us? If we are really talking about whether it's cancer or another illness as if we're going into battle, and ultimately, we're going into battle with our own body. So if we are going into battle, there has to be a winner and a loser. It's no different from any war that we're used to in history class or any wars that happen right now. There's going to be somebody who's going to come out victorious and somebody who's going to be a loser. Is that the approach we have to take? Is it just that that's what we have heard, that's what's been modeled for us, that's what society has taught us? And so it feels good. It feels like, "Yeah, we're going to fight this." And so we have this internal, "Yeah, maybe this will fire me up if I feel like I'm going to go into battle and I'm going to put on my boxing gloves and I'm going to win this thing." Is there a better approach? Can we start to shift that into, instead of being at war or an adversary to our bodies or our bodies being the enemy, can we actually come back to it being an ally? So is it possible that the symptoms that we're experiencing, whether it's...

A competitive environment can prevent healthcare organizations from engaging online. Justin Poulin shares his insights into the untapped potential of social media with Jim Cagliostro. Episode Introduction Justin explains why the key to a successful podcast is consistency, how the pandemic masked issues with supply chain workforce shortages, and how silos in healthcare hold people – and organizations - back. He also explains why competition makes people fearful of social media, provides key tips to getting started and explains why ‘’chasing the money’’ will always leave you dissatisfied. Show Topics 02:56 Consistency is the key to successful podcasting Justin said creating a regular schedule is the most important factor for long-term success. ‘’….podcasting, so much of it is a soft skill. I could give you little tips and pointers, but the most important thing about podcasting, and you're doing a great job with this, it's just being consistent. Making sure that you are putting content out on a regular schedule that people know what to expect. I see a lot of startup podcasts and they come out with a lot of gusto, and they do a bunch for about two or three months. And then, all of a sudden, there's a four-month gap. And those ones never really take off. I've always told everybody who wants to get involved and do it, "Hey, nobody's trying to own this space. It's a fun, creative outlet. But one of the things you have to do to be good with it is make sure that you are constantly putting out consistent content." You could do a podcast once a quarter, as long as you deliver it once a quarter on a schedule that people can expect…..It's like the TV series that comes to this great cliffhanging end of season two, and then they don't get renewed. And you're just left going, "Why? Why did you do this to me?" And so, yeah, that's the experience. And so, if you're doing podcast, just stick with it.’’ 11:24 Bring your whole self to an organization Justin said healthcare can be siloed but merging skills and interests benefits every organization. ‘’…what a convergence of my passion to do this radio show podcasting, my clinical background as a nurse, and then this entrepreneurial sales side. It's all just merged into this role and what this company is. And who would've thought all of that would've intersected, what I was doing? And I saw it as something separate. So I'd also encourage people to consider their diverse interests and experiences. And not try to partition or segment them but, actually, bring them to the table and bring their whole self to their employer, or help them create their dream job for themselves. It's really important that I think a lot of times we're taught diversify your revenue streams, you hear that, so it's all segmented. And you think about healthcare and it's very siloed. But we actually do that to ourselves. We silo our skills and interests, instead of merging them into what makes us a unique human being, which is, ultimately, how we can bring the most tremendous value to any organization that we're involved in.’’ 14:28 The supply chain workforce shortage came in under the radar Justin explained the impact of the pandemic on staffing shortages. ‘’I feel like the supply chain shortage, or workforce shortage, is sneaky. It came in under the radar. I'm sure people in supply chain might've been aware that it could be become an issue, but I don't think it was as transparent as the one that everybody talked about with nursing. We could have planned better, for sure, but we knew it was coming. I think some of the things that had happened with supply chain was really the emergence of strategic sourcing and these other roles that, at one point, when you said supply chain, in a lot of ways, you meant logistics or materials. And maybe a little bit of contracting and purchasing. But what has happened since the Affordable Care Act and value-based purchasing is we've now really expanded on the skillset...

Marketing effectiveness has fallen by nearly a quarter since 2020. Ian Baer, Founder & Chief Soothsayer at Sooth, offers his insights on how healthcare organizations can respond, with Jim Cagliostro. Episode Introduction Ian shares how 90% of today’s marketing decisions are emotional, and 80% are made on impulse, and the challenges of ‘’marketing by the pound.’’ He also explains why a regulatory environment means healthcare often stays in the shallow end of the marketing pool, how data unlocks empathy between brands and audiences, and advises everyone to ‘’bring your soul to work every day.’’ Show Topics Making emotional connections in marketing Sooth helps brands to understand the truth Healthcare has unique marketing challenges ‘’Marketing by the pound’’ The roadmap of healthcare marketing is the most complicated The power of patient stories Leadership tip: Bring your soul to work every day 08:13 Making emotional connections in marketing Ian said 90% of the decisions people make when spending money are emotional. ‘’AI, it's very buzzwordy, but what it does for us is it allows me to take what used to require one or two years of custom research that might cost hundreds of thousands of dollars, into a methodology that we can execute in a few weeks to give a brand a very clear understanding of the emotional journey of the individual that they're trying to reach. Now of course, the impact in healthcare is huge because look, 90% of all the decisions people make when it comes to spending their money are emotional. It's a big mistake marketers made for decades upon decades in thinking there's a balance between the rational and their emotional. No, there isn't. People make emotional decisions, and then they seek rationale to back up where their heart has already gone. And Harvard did some brilliant work that they published in 2016, an article I recommend to anybody and everybody get their hands on, called The New Science of Customer Emotion. .. And what they found was, of the thousands of different emotions we all experience, it's been estimated that people experience 34,000 different emotions. … But what they found is there are actually only 10 things that we feel as humans that have a positive correlation to the way we spend our money.’’ 14:54 Sooth helps brands to understand the truth Ian explained the background to his company name, and its purpose. ‘’So, I went looking through my LinkedIn profile, just going through all my experience and, "How can I describe what I do?" And I found a LinkedIn recommendation from a former client in which he referred to me as, "Soothsayer." And it reminded me that very often, when we were at a time of crisis for his brand, he would pick up the phone and call me and say, "Oh, soothsayer." And that would very often start our conversations. I thought, "Well, that's a really interesting word." I always thought a soothsayer was somebody who predicts the future. It's not. Soothsayer is somebody who tells the truth. The word sooth literally means truth. It just went obsolete in the English language about 400 years ago when Shakespeare got done with it, which is what enabled me to actually trademark it as the name of a business. It's pretty hard to get a vernacular word as the name of your company. So, when we decided to name the business Sooth, because in reality that is exactly what we're doing is helping brands understand the truth, then it just followed suit that I should be the soothsayer, that we actually have two practices at the company. We have the soothsaying practice, which is determining what the truths are, and then our client partnership practice, we call those people ‘’soothsolvers’’ because what they do is actually take the truth and put it to work in really smart marketing recommendations, and work in partnership with senior leaders on the client side.’’ 17:23 Healthcare has unique marketing challenges Ian said the regulatory environment means that...

US health systems are slowly adopting a patient-focused approach. Shanil Ebrahim, Partner in National Life Sciences & Healthcare Consulting Leader at Deloitte Canada, explains its benefits to Jim Cagliostro. Episode Introduction Shanil explains why healthcare needs to move away from the ‘’one-size fits all’’ approach to patient care, why patients should be treated as partners, rather than recipients, and the impact of a healthcare model designed around systems. He also outlines why patient-centered care is an investment in quality and efficiency and highlights the benefits of adaptability in leadership. Show Topics Patient care goes beyond managing health conditions Healthcare is designed around the needs of the system ‘’Patient feedback should shape everything we do’’ Funding the cost of change A champion for patient care Improving the patient experience leads to better outcomes Leadership tip: embracing adaptability 05:12 Patient care goes beyond managing health conditions Shanil said patient-centered care is designed around patient preferences. ‘’Ultimately, when you think about that term, at its core, patient-centered care is about ensuring that healthcare systems and all of their processes are fundamentally designed around the patient's needs or their experiences or their preferences I should say. And this approach goes beyond just treating diseases or managing health conditions. It's about considering patients as active participants in their own healthcare, which means that any sort of treatments or healthcare plans we develop, it's not about just focusing on clinical guidelines alone, but how do we deeply integrate that with the individual's lifestyle or their cultural background or their personal preferences into how those treatments are actually planned and executed?’’ 10:45 Healthcare is designed around the needs of the system Shanil explained how the historical context of healthcare models affects patient care today. ‘’…your question really gets at the heart of many challenges that we face in healthcare today, irrespective of where you are, whether you're in North America or globally, and you have to consider that historically, our healthcare models were designed more around the needs of the healthcare system than the needs of the patient. All you have to do is look at things like financial models of all of these health systems, which is focused on volume and paying for services that a doctor provides over value of the services or take healthcare organizations like hospitals where they prioritize operational efficiency, where you have a ton of metrics around that over personalized care. And even though we may make patient-centered care sound easy and obvious, transitioning to that type of care is a big paradigm shift when you consider that historical context. And it requires both a shift in mindset and operations.’’ 11:48 ‘’Patient feedback should shape everything we do’’ Shanil explained why the starting point is to consider the patient perspective. ‘’And to me, first and foremost, it starts with leadership commitments, whether your ministers or C-suite execs at hospitals to re-envision what healthcare should look like from a patient's perspective. And this means aligning the organizational culture with patient-centric values and training your workforce to adopt this approach in every interaction in every decision. And when you think about what are practical first steps that you can actually take, it often involves gathering extensive patient feedback to understand their experiences and needs better. Something that we talked about obviously just at a length. And this feedback that we get from these patients should shape everything we do from policy to bedside manner. And technology plays a pretty crucial role here because it can be leveraged to improve communication with patients. It can be leveraged to offer more personalized health management tools or provide healthcare...

Strategic planning is vital to successful healthcare management. President & Co-Founder of The American Healthcare Journal, Cole Lyons, explains his goal of fostering a community of education to Jim Cagliostro. Episode Introduction Cole explains why transfer of knowledge is a key goal of the Journal, why healthcare strategy can be described as moving from checkers to chess and emphasizes the importance of thinking before you speak. He also explains the importance of competition in healthcare and identifies humility as an essential leadership trait. Show Topics Redefining healthcare strategy A strategic alternative for nonprofits Breaking down silos in healthcare Join Cole’s community on LinkedIn Applying economic theories to healthcare strategy Leadership tip: why humility matters 05:36 Redefining healthcare strategy Cole explained why thinking about the impact of your actions matters. ‘’For me, it's kind of thinking before I speak. I think that's the best way that I've come up with how to explain it. In operations, day-to-day, things are quite hectic, especially at high volume clinics. And you have to make very quickly, fairly educated decisions based on standard operating procedures. But sometimes that doesn't always lead us down the best path. So part of that is creating standard operating procedures that allow you time to think about how it impacts things long-term. So, thinking before you speak for me means instead of just saying what I need to say in the moment, I think about what I say, how it will impact the person hearing it, how it'll impact my image. And if you apply that kind of thinking before acting approach to your actions in the operations space, it means taking a step back and looking at the competitive landscape in your industry, looking at the competitive landscape in your institution, different departments competing for funding, different departments competing for exposure, and looking at how even small actions in the operations world will impact that.’’ 08:12 A strategic alternative for nonprofits Cole said the Journal aims to foster improvement and education in strategic thinking for nonprofit institutions. ‘’… the problem right now is VC-backed healthcare firms, those that are backed by venture capital. They have a high concentration of MBAs who have really good strategic insights. So don't get me wrong, and we can always go into this anytime, but there's a problem with a lot of the strategy theories out there in general that are taught to MBA graduates because it's based on economic theories that don't always play out in the real world. But still when they make decisions, it is much more strategic than in nonprofit healthcare. And so, one of the issues is that I'm not a fan of government-run healthcare, which is a little contrarian. I'm just not particularly a fan of it. I think that free market healthcare is good, nonprofit institutions are my favorite. I love nonprofit institutions. I think that that's the best form of delivering healthcare. But they don't act very strategically, especially compared to VC-backed or for-profit healthcare, which employ all these MBAs, they recruit MBAs from the top schools, they can pay them. …I'm not saying that they're any less educated, they're just educated differently. They have MHAs, they have MPAs, a lot of them have MDs, and they are educated in a very different way. So the journal's purpose is how can we foster this community of improvement and education in strategic thinking for these people who are educated in a much more practical way? An MHA isn’t sitting in their office thinking and going into philosophy a lot of times. A lot of times they're figuring out, how can we solve this problem? How can we deal with this emergency situation?’’ 13:36 Breaking down silos in healthcare Cole said administrative fellowships can help to develop a well-rounded approach. ‘’One of the ways that this is going to work out really well, and a...

Tech startups are predicted to disrupt US healthcare in 2024. Scott Nelson, co-founder, and CEO of venture backed FastWave Medical, offers his strategies for success in innovation with Jim Cagliostro. Episode Introduction Scott reveals the two signs that an idea has potential, why market trumps everything in innovation, and why leaders should focus on eliminating pain points for their end users. He also advises innovators to connect with potential strategic acquirers at an early stage and explains why leaders of startups shouldn’t put all their eggs in the venture capital basket. Show Topics Two signs of a good idea Market ultimately trumps everything in innovation Engage with potential strategic acquirers at an early stage Finding investment in your community Flipping the script: eliminating pain points Effective ways to raise capital Leaders of startups don’t have to be the CEO 05:49 Two signs of a good idea Scott said there are two things for leaders to consider in innovation. ‘’I guess to answer your question in a little bit more long-winded way, I would say if you've got an idea that you can't seem to shake a little bit… It's sticky and you find yourself maybe waking up at night thinking about it or you thought about it and then two weeks ago you're still thinking about it, maybe a month goes on, you're still thinking about it, that's usually a good signal. Maybe there's something there, but the most important point from my perspective is before you go too far, before you get too latched onto this idea, you really need to think about two things primarily. One, does it solve a real glaring problem? Is it a painkiller? I remember interviewing Dan Hawkins way back in the day. He was actually the founder of Shockwave, the company I mentioned previously, was very early at Intuitive Surgical, was the founder of Avail Medsystems, et cetera, serial entrepreneur. And he phrased, this was back in, I think 2016 or 17, but he mentioned finding a painkiller, not aspirin, not Tylenol, but a real painkiller, something that really causes a lot of pain, whether that's from a cost perspective, whether that's from a workflow perspective, but something that's like, there's a lot of friction there. That's what your idea hopefully solves for, a real painkiller. And then secondarily, if you think you're onto something that solves that real pain point, secondarily, you need to think about this as early in the process as possible. Who's going to pay for it?’’ 09:03 Market ultimately trumps everything in innovation Scott explained why market is the #1 factor for potential entrepreneurs. ‘’I sort of fundamentally believe that market ultimately trumps everything else, right? Now, don't get me wrong, you could have a great product and a great team, but if it doesn't serve a huge market, you're going to have to think about other ways to fund that, right? Maybe it's a product that you can invest your own money in. Maybe it's a product that you can get to market quite quickly and use revenue and profits to support the company's growth, etc. But the reality is you need a big market to serve in order to give you optionality to capitalize and fund your idea or fund the company moving forward. So I do kind of think market trumps everything, because again, you could be working on a great product, have an awesome team, but if the market just doesn't support it, it's likely not going to have a lot of substance there. On the flip side, you could have an awesome market and maybe a decent product and a decent team, but it's probably going to do fairly well because the market supports that need. So, long story short, there's a couple of different ways to think about it. They're all important. ‘’ 12:38 Engage with potential strategic acquirers at an early stage ‘’Obviously you need to be careful and cognizant about not disclosing too much, but the imperative is really to start engaging early on with those, what you perceive as...

Purchased services is often the most overlooked expense in healthcare yet offers opportunities for cost savings. Brian Bartel shares his best practices for effective contract management, with Jim Cagliostro. Episode Introduction Brian explains the unique challenges of purchased services, why a centralized contract repository is the first step to successful purchased services management, and why hospitals should never allow contracts to auto-renew. He also explains why ‘’red flags’’ aren’t always necessarily malicious and why it’s vital to question the line-item details of your purchased services invoices. Show Topics Purchased services present a unique challenge in healthcare #1 tip: Create a centralized contract repository Review your contracts on a minimum annual basis Don’t assume all red flags are malicious The hidden cost savings in your line-item details Be inquisitive, be patient, be strategic – and build relationships 06:35 Purchased services present a unique challenge in healthcare Brian explained the difference between supplies and purchased services. ‘’…When you're talking about supplies, it's pretty easy. You've got a specific item number, you've got your power set, your requisitions, everything is very orderly. So things are coming in, you can track it, you've got the data behind it, there's a contract with that line item pricing. And then when you get confirmations back, usually people are using some form of EDI, which makes it relatively easy, and you can track that. Item A is item A, item B is item B. Purchased services is different because it typically is not on a PO. Again, I've worked places where it is, but that comes with its own challenges. It's very department specific, so you've got usually a department manager or leader that's kind of running that point with it. We don't have as much interaction on the supply chain side of this either. Communication is usually kind of sparse between supply chain and a purchased service provider as compared to a typical supply vendor. And again, the data is just, it's more difficult. When you start looking at how things are being invoiced because there's no PO line, it gets very challenging to try to figure out, "Okay, what's actually happening with this spend?" Typically, an invoice will come in, the department manager signs off on it, it gets paid, and that's it. So a lot of opportunity there.’’ 08:30 #1 tip: Create a centralized contract repository Brian said a centralized contract repository was the essential first step to successful purchased services management. ‘’I think that at square one, I think the biggest thing you can do is if your organization or your hospital, your ASC, your clinic, whatever it is, if you don't have a centralized contract repository, that's step one. Again, stepping into certain roles in my past, you've got contracts that might be down in admin. You've got department managers that have signature execution authority and they've got them in their files, and then you realize three years later that there's been this contract that nobody's really paying attention to because it's just a paper copy. Really I think that that's the biggest thing for me is getting your hands around it. Number one, you've just got to have that centralized repository. Again, that doesn't mean that you need to use software. Software obviously makes things easier. I'm a big proponent of that. But again, even just saying, "All right, nobody can sign contracts except for," whether it be your CEO, your CFO. "Send all these down and we're going to put them in a file cabinet." At least then you can go and try to find where those contractual documents are.’’ 10:07 Review your contracts on a minimum annual basis Brian said it’s important not to let contracts auto-renew. ‘’It’s always good to have that check-in annually, even if it’s just pulling the contract, making sure when does this contract terminate? That’s the other thing about...

Flourishing supplier relationships can transform healthcare organizations. Samer Haddad, shares his experience of building and navigating successful partnerships with Jim Cagliostro. Episode Introduction Samer explains why trust is the foundation of all successful supplier relationships, the importance of human-to-human connection and why a partnership sometimes means giving your partner the benefit of the doubt. He also outlines the key to a successful exit strategy (plan, plan, and plan) and why solid leadership means treating others as you want to be treated, and leaving your ego at the door. Show Topics Supplier relationship management isn’t just a keyword Trust is the foundation of successful relationships Managing multiple suppliers is about more than spend ‘’Partnership is a partnership’’ Managing a successful exit strategy Leadership tip: keeping your ego out of the way 04:33 Supplier relationship management isn’t just a keyword Samer explained how the impact of Covid revealed the importance of strong supplier relationships. ‘’When the world went into COVID and all the crises that came after that, in terms of shortages and everything, I can make a pretty easy judgment that there was a big differentiator between companies who made it and who maybe struggled mainly was supplier relationship management. Because when the real challenge came to the world, companies that invested in relations, companies that had deepened their relationships, especially with the significant suppliers to their production or to their delivery, whatever that is, made a difference. Those were the ones who were able to actually leverage that challenge to their benefit in the market. So they gained market share. The ones who had superficial relations, maybe more towards purely commercial kind of dealings, I think they struggled because, at such a moment, that kind of... I can't call it a human-to-human relation, or personal relation is where things are tested, and when companies need to make decisions, that's always an element. The trust between those organizations is essentially trust between humans that are doing business for years together. So if you just... we learn from the past two to three years it is I think many of my peers in procurement supply chain will vouch to the importance of supplier relationship management in general and not just like a keyword that you use and throw around…’’ 07:09 Trust is the foundation of successful relationships Samer said KPIs can help to measure progress and build trust. ‘’It takes time to build up that trust. So it is very important when we start a relationship that we create the proper agreement because this is why contracts are there. Contracts manage the relationship between parties. And you're establishing basically a baby kind of relation that has no trust yet, and you need to monitor it and start putting in the building blocks of that relation. Usually, in my opinion, that is established by having mutual mechanisms to judging how companies are engaging with each other. That could be the KPIs that you set. And it's not fair only to set a KPI for the supplier that you're establishing a relationship with, especially if you're looking long-term. Some KPIs should be set, maybe not in the contract, not necessarily, but self-imposed as you manage that important relationship that you know about. So you can even monitor internally how you're engaging with that supplier. Now, if you do that kind of fundamental layer of developing that relationship and you start building upon it, with time, trust starts getting improved and starts growing. It's like a baby, and it grows. It becomes an entity.’’ 10:24 Managing multiple suppliers is about more than spend Samer said organizations need to understand how suppliers can impact their business. ‘’…... But let's say what are the top 10 suppliers that basically can make or break your business? Because each business needs to know these...

An estimated 40% of expenditure in the supply chain goes to waste. CEO Luká Yancopoulos explains to Jim Cagliostro how Grapevine Technology aims to put the power back into the hands of hospitals. Episode Introduction Luká explains how Grapevine can help hospitals save up to 80% on a single line item, how even small healthcare businesses spend six figure sums on the supply chain each year, and how to frame the reality of years of overspending to his clients. He also reveals three key ways that hospitals can lower the expense of their vendor management. Show Topics The power of building networks Supplies are a huge expense in healthcare Up to 80% of spend may be waste Connecting the source of supply to the end user Framing harsh truths on expenditure Seeing value every step of the way Leadership tip: deliver solutions to real problems 03:12 The power of building networks Luká said Grapevine can help its clients to save 70-80% on a single line item. ‘’So Grapevine is working to make it very easy to basically manage your existing network. We've got healthcare businesses. They usually come to us, and they've worked with a handful of suppliers over the years. They think of each of these suppliers as their supplier for blank, fill in the blank, and Grapevine rewrites that. We think they're all your suppliers, they're all your network. Every time you add an item to cart from one of them, let's make sure it's the best price and that your other suppliers that you already trust and know don't have the same exact product at a cheaper price. Oftentimes, they do. We've basically redirected spend from one major distributor to another major distributor, saving the customer or the healthcare business 70%-80% on a single line item. The thing like a Becton Dickinson or a BD catheter or infusion pump or something they buy, and they have a bad habit of buying it from the wrong guy. So we basically let them link all their suppliers with the click of a button to a single screen, read in their current offerings, and tell them where to redirect their spend, acting as a traffic cop if needed.’’ 05:14 Supplies are a huge expense in healthcare Luká explained that even small healthcare businesses are spending six figure sums on supplies every year. ‘’Certain medical specialties get hit harder than others. If you're performing surgery, obviously, you're burning through a lot of supplies, you're using anesthesia, you're using all sorts of things that maybe your average urgent care clinic won't need. So we focus on specific specialties that have a high consumption rate of important and expensive technologies, things like oncology, dermatology, surgery, these sorts of things. Even a small healthcare business is spending six, seven figures on medical supplies and pharmaceuticals, like, a customer that comes to mind, a family-owned dermatology practice in upstate New York, and Rochester, New York is spending $200,000 a year pre-Grapevine on medical supplies. So like the instruments and whatnot, they're using sutures and implants and this and that, and then they're spending another million a year on injectables. Things like lidocaine, fillers, and different sorts of things of that realm.’’ 08:38 Up to 80% of spend may be waste Luká explained why a single supplier can’t offer hospitals the lowest price for every item. ‘’I think that, in some cases, it's as much as 80% of the spend on supply is fruitless and extraneous. As far as what makes up those inefficiencies, there's a number of things. There's a classic idea that I am a strong believer of, that no one person or entity can be the best at everything. So even if you're comparing suppliers of the same business model, these large distributors, we could talk like McKesson, Henry Schein, Medline, the list goes on and on. Every one of those has built supply chains like warehouse fulfillment, shipping teams, customer service, et cetera, tailored around a specific core competency...

The US healthcare sector has struggled to put innovations like AI into practice. Mara Cairo explains the advantages of applying machine learning and AI for hospitals to Jim Cagliostro. Episode Introduction Mara explains why the first step towards successfully embracing AI is literacy, the challenges hospitals face in system integration and why AI isn’t intended to replace humanity in patient care. She also illustrates the benefits of AI for healthcare, including predicting patient no-shows, effectively managing inventory, and reducing costs, and explains why successful leadership means getting out of the way. Show Topics Taking the first step towards AI literacy The challenges of AI in healthcare Applying AI across industry sectors Anticipating patient no-shows The impact of AI on cost reduction initiatives Leadership tip: Hire the right people and get out of their way 03:48 Taking the first step towards AI literacy Mara said AI literacy helps to overcome resistance to AI. ‘’Really the most important thing is AI literacy. It's just like learning what AI is, what it isn't, the types of problems it's really great at, the types of problems you shouldn't use it for. On the earlier side of the spectrum, we have lots of training and education really meant to get industry partners, but also the general public. We're working even with K-12 teachers and students now ... to make sure that everyone has that literacy because it's just becoming more and more important to kind of arm yourself with the information because we're being inundated with information and news articles and scary stories. So it starts with literacy, that's the first part, and then kind of evolves from there hopefully.’’ 05:46 The challenges of AI in healthcare Mara said the complex needs of healthcare mean hospitals struggle with system integration. ‘’There are different disciplines. Each maybe has their own labor agreements, regulation and whatnot. So when we think of human resources as a piece of inventory, that gets quite complicated quickly. Another thing, supply level. Inventory levels are complex. We kind of all saw it in COVID. The demand can spike really, really quickly. And you don't necessarily know when that's going to happen, right? So these surges can catch everyone off guard. And maybe traditionally it's been harder to anticipate when these surges might appear. Luckily, maybe machine learning is a tool that can help us with that. Also, just I think the shelf life of different supplies is unique to healthcare. You have to be really, really careful about storage and transportation requirements. And all of that is compounded by distance and transportation costs. Especially in Canada, in the far north, those care locations, they're really dependent on certain supplies, but if there's a road closure or a snowstorm or something, it's further complicated. The inventory supplies and healthcare are potentially life changing, right? So it's just so much more important that that is managed properly. And that complicates things. I think overall, in general, we've just seen that healthcare systems can struggle with system integration.’’ 08:30 Applying AI across industry sectors Mara gave examples of how AI helps with demand forecasting and warehouse management. ‘’Some of the really cool projects we've worked on with our industry partners in the supply chain space, but more in the kind of consumer goods area are things like demand forecasting. So helping them better predict what items they're going to need and when. What's really great again about working with our supply chain partners is they have a ton of data, historical data. And that's really, really important. When we start looking to build machine learning solutions, we often rely heavily on that historical data to be able to make those predictions about the future. So the demand forecasting problem is really ripe for innovation and for machine learning because usually there is...

2024 has been described as a financial ‘’make or break’’ year in healthcare. SpendMend Research Supervisor Zachary Markham explains to Jim Cagliostro why time and data are money for hospitals. Episode Introduction Zach explains why the lack of timely, accurate data can delay recovery of credits, and why most hospitals only have 50% visibility into their spend and accounts payable processes. He also shares why duplicate payments and credit on spend are the top two methods for recovery of costs, and highlights how uncovering dark data saved SpendMend clients $413 million in 2023. Show Topics Data analysis identifies duplicate payments Timely data is vital to maximize cost savings The significant cost savings potential hidden in dark data 3 challenges to gathering hospital data Positivity and communication skills are essential in leadership 02:18 Data analysis identifies duplicate payments Zach provided a ‘’birds eye view’’ of data analysis. ‘’So, when we initially get a client's data in, a hospital's data, we jump right on that data and we go ahead, we search account numbers and vendor contact information for each. So, if it's a larger healthcare system, we'll search for each entity within that healthcare system. We'll search for account numbers for all those, as well as the contact information for vendors. And then, for duplicate payments, that's a large revenue stream for us. So, that starts in the data scrub team. They scrub down the data and identify some good potential duplicate payments. And a duplicate payment is just an invoice that was paid twice for one reason or another. And once the data scrub team is done with that, they'll pass it off to us and we'll go into our client's imaging systems, where they store their invoices and we will pull those invoices and pass it back over to the data scrub team for validation. And I guess the third one here would be just various invoice pull requests for other departments, including the tax team, purchased services, as well as med device, just to name a few. And then, the last one I'll cover here just for the bird's eye view, PHIQ, which is protected health information. So, we've talked about data and it's extremely important to obviously protect our client's data, but it's equally, if not more important, to protect the patient's data as well.’’ 05:24: Timely data is vital to maximize cost savings Zach said hospitals sometimes don’t obtain credits for years if price discrepancies aren’t found quickly. ‘’I'll give you an example from my time as a pricing analyst. So, as a pricing analyst, we would review data price discrepancies that were about one to two years old from present from what they were currently paying, the hospitals were paying. So, we'd go through identify, "You're paying this vendor $20 for this item, when you should be paying $10 for that item," just as an example. And we would get that and working one to two years behind them. I guess the quicker that we would finish our review and then turn that back into the client, they'd be able to mend the price that they're paying, get it back to the contracted or agreed upon price. And also, collect the credits that were outstanding for the time that they were overpaying. So, I guess the sooner you can identify that you're paying at a higher rate than the contracted price for items, the sooner that you can correct it and get credits from the vendors.’’ 07:44: The significant cost savings potential hidden in dark data Zach said hospitals only have 50% visibility into their spend and accounts payable processes. ‘’Dark data is information that is hidden or not visible to a hospital for a variety of reasons. But it comes down to them not having the time, resources, or insights to uncover their own data blind spots. And I like to think of this kind of as a puzzle. So, when a hospital or healthcare system hands over their data to us, they're giving us basically a half put-together puzzle, and it's...

US healthcare is facing a severe shortage of workers at every level. 6.5 million are expected to leave their jobs by 2026. Geoffrey Roche addresses the challenges in building a new workforce with Jim Cagliostro. Episode Introduction Geoffrey highlights the impact of the current staffing crisis in healthcare, and why leadership needs to evolve from a transactional to a heart-centered approach. He also explains why delays to access in care can cost hospitals up to $1 million every month, how one community college turned away over 13,600 qualified students from a program, and why every healthcare leader should become a mentor. Show Topics The impact of an ongoing workforce crisis A changing approach to healthcare leadership Industry and academia must connect to support the workforce Access to care delays may cost hospitals $1 million every month Delayed care leads to poorer patient outcomes and higher costs Qualified students can’t access vital healthcare programs All healthcare leaders should mentor 02:33 The impact of an ongoing workforce crisis Geoffrey said the staffing shortage, combined with retention challenges, are impacting access to care. ‘’… we sit at a huge inflection point. Probably without question the most challenging time in our nation's healthcare workforce is, as we speak today, certainly not that dissimilar from 2023. And when we look at it, we've got a significant supply and demand challenge. We know that there are not enough individuals graduating from college in pretty much every aspect of a healthcare program. We also know that retention still remains a very significant challenge, whether it's a clinical role or a nonclinical role. I think we have to be honest though about the impact that we are all seeing and will continue to face, particularly in the licensed areas of our healthcare system. It doesn't go a day where I talk to somebody and they share an access to care delay, whether it's in imaging, whether it's in lab, whether it's in outpatient or inpatient services. We're certainly at a very, very difficult time.’’ 06:00 A changing approach to healthcare leadership Geoffrey said leaders in a multi-generational workforce need to demonstrate empathy and not judge. ‘’I think leadership as a whole is taught very differently, right? And different points in time, different generations, the way that they have been taught leadership in some ways was command and control, which some would argue is more like transactional. And as we further see, we've got how many different generations, some people say five, some people say six. Whatever the number is, we've got more generations in the workforce than ever. And what we know is that our younger and our future generations have a much different view of leadership than previous ones. And we know that connection, respect, empathy, really this desire to understand that it's not going to just be the status quo, is not going to be the future of leadership when we look at all the different generations. And so it's really incredibly important that we have leaders in healthcare that can relate and understand and demonstrate empathy and not judge. I always say nobody should be judging on generations. I am the first to say I'm a millennial, but that doesn't mean right away go in and talk about, "Well, millennials leave jobs." That has no business in this conversation. What does have is how do we work together to achieve outcomes and results? And ultimately, I think if a leader can find connection with a person and help drive them, mentor them to achieve results, everyone's going to be rowing the oar in the right direction.’’ 08:08 Industry and academia must connect to support the workforce Geoffrey explained why collaboration is vital to improve access to care delays. ‘’….we have significant access to care delays in the healthcare system today where whether you're going for an imaging study, whether you're waiting to get an appointment for...

Tom Pierce, the President of Integrated Information Systems Incorporated provides valuable insights based on his diverse background in problem-solving, logistics modeling, and consulting. Introduction Our guest, Tom Pierce, the President of Integrated Information Systems Incorporated provides valuable insights based on his diverse background in problem-solving, logistics modeling, and consulting. The episode explores the impact of technology and human behavior on the supply chain, challenges in decision-making related to expenses and stock management, and the importance of honesty, transparency, and human connections in supply chain management. Topics Covered The mindset required for effective decision-making in healthcare expenses The social and psychological dimensions of business decisions Transparency and human connections in supply chain management Data quality challenges and human intervention with digital technologies Overseas supply procurement and its implications The importance of truthfulness in buyer-supplier communication The bullwhip effect and technology's role in accelerating it Cost-risk versus schedule-risk: organizational motivations The impact of just-in-time vs. just-in-case inventory strategies 2:45 The Impact of Technology on Problem Solving "Once computers made their appearance, and yes, I am so old that I learned how to use a slide rule and the calculator was in advance, so I'm that old, but as computers came on the scene, the only reason I was interested in them was because they could help me do things to solve problems quicker, more efficiently, all of that. So I've grown up with the introduction of technology into previously very human, very brute force, mental math, pencil and paper, problem solving, but it's very hard to condense 40 years of what technology has done to the ways we solve problems and the ways we create new ones. Everything we did humanly good and bad has been accelerated and amplified by technology.: 6:17 The Impact of Technology on Human Behavior "It's rather amazing how much our computers have been created in our own image and exemplify, manifest the same flaws that we as people exhibit when relating to each other, but it's less inhibited." 10:34 The Impact of Financial Incentives in Organizations "I don't think that's a bad thing. I think people should be rewarded financially and get fairly compensated for their investment in in technology, you know, and people that do well should be rewarded for doing well. I got no problem with that." 13:26 "Just in Time Inventory Practices" Well, if it's not broke, don't fix it. Well, that doesn't mean don't have spare batteries. When my flashlight goes out in the middle of the night, I want to be able to go into my pantry or my workshop and get more batteries, but that's not lean unless you can predict exactly how many batteries you're going to need and then the ideal becomes, "Well, we'll just have an Amazon ready to deliver to batteries same day," and just reduce and reduce and reduce the carrying cost of your inventory, and I blame the Walmarts and the Targets of the world for doing just that. They leaned out their own cost by offloading those costs to their suppliers, so the just-in-case part, right? In case of disaster, well, that's your vendor's problem, because your big and powerful and you can insist, if you want to do business with us, then you've got to maintain stockage objectives and you've got to reply 24/7 replenishing my shelves, because I don't want to maintain a big warehouse. I just want to move parts through. 15:07 Just in time versus just in case "If your only motivation is profit, that's a really good business model for a finance person. Mhmm. It's not a great business model if what you're really trying to do is continuously improve your product and your service and the delivery times and, you know, customer lead times, all that." 19:30 The Deception Game in Business “I need to...

After 25 years and $1 billion of hospital cost savings, Lisa Miller is joined by Rich Dormer, Bryan Covert, and Pandu Mitre to celebrate this landmark episode of THLE. Episode Introduction Together, the team discuss the cost savings surprises of 2023 and look forward to 2024. Insights include the two-tiered approach to cost savings goals that all hospital leaders might want to consider, and why difficult vendor negotiations will continue in 2024. The team also review the potential impact of AI on cost reduction, why finding hidden costs always comes back to line-item data, and why every hospital needs a spend data strategy in 2024. Show Topics Building strong teams in a post-Covid era Vendor negotiations became more difficult in 2023 ‘’It always goes back to the line-item analytics’’ A two-tiered approach to cost savings goals The hidden cost savings in AI Vendors will continue to say ‘’no’’ in 2024 Two keys to an efficient supply chain More buying power doesn’t always equate to ‘’best pricing’’ 02:26 Building strong teams in a post-Covid era Rich said healthcare systems are hiring people with a broader skillset that need an accelerated learning curve. ‘’…one of the biggest things that we saw this year, or I saw specifically was a lot of organizations were building those sourcing and supply chain teams. Where in the past they've been really lean and relying on GPO or other types of resources. But with COVID and the need to really do a lot of contracting, a lot of complicated agreements, most organizations recognize that they really needed to build their teams. But the issue that a lot of them have is that there's really only a limited pool of seasoned players on the market essentially. Therefore, when they look to hire, they're hiring a lot of people that are either early in their careers or they come from a different industry which when we look at healthcare it's really unique and complex. So bringing someone from the manufacturer industry coming in and looking to do a sourcing or some sort of negotiation in healthcare, it's very different. So with these large obviously needed cost savings goals for organizations, these newer teams that are being put together need to really accelerate their learning curve. So we've seen a lot of conversations around the support that they need. Right? And probably the biggest one that we keep hearing is that access to data, really that line-item invoice level data is critical to be able to do these large initiatives that a lot of them are working on now and they struggle to get that information. Because the biggest piece is to really do analytics around it and they're doing it off of projected data or vendor supplied information which is not always accurate. So those are the biggest pieces for a lot of these teams coming in and really trying to meet these aggressive goals that are needed for these organizations to maintain their profitability and not only with analytics and data but also negotiations.’’ 12:06 Vendor negotiations became more difficult in 2023 Bryan said utilization and market data are just two elements hospitals can us to combat vendor refusal to reduce costs. ‘’I think the most surprising thing for me was just how difficult negotiations with vendors became in 2023. To your point and Rich's, point earlier we saw on the hospital side more investment in supply chain teams, probably some of the largest cost savings goals we've seen at our clients throughout the years. Just because costs were going up and they're trying to come up with ways to combat them, the vendors had a really solid narrative. We had 8% inflation; their costs were up. They're also coming out of a time with COVID where a lot of the vendors had to really step up in supply services and crunch time, so they really developed stronger relationships with the stakeholders at the hospital. And then we're seeing in 2023 the vendor is more willing to tell supply chain no to cost reduction,...

After labor, the supply chain is healthcare’s biggest expense. Randy Subramany, Director of Supply Chain at New York Presbyterian Hospital, shares insights into 2024 trends and innovations with Jim Cagliostro. Episode Introduction Randy explains why there’s more to his role than ‘’bandages and gauzes’’, why people are the most important element of the ‘’three-legged supply chain barstool,’’ and highlights why patient care, decision-making and retaining talent are the top supply chain challenges. He also explains why it takes an eco-system to keep people healthy and how tapping into the power of technology can improve slim hospital margins. Show Topics A day in the life of a Hospital Supply Chain Director Caring for patients with complex health needs Challenges in retaining and growing talent The impact of digital transformation on healthcare Utilizing technology to promote a sustainable economy Supply chain management: improving margins Leadership tip: Going to the Gemba 02:26 A day in the life of a Hospital Supply Chain Director Randy explained the far-reaching impact of the role and his team. ‘’People think about supplies in a hospital, I'm sure the basics, whether it's through a TV show or just walking through a hospital, you'll see the fundamentals, you'll see gloves, you'll see gowns, you'll see all the different forms of PPE, people think bandages and gauzes, but let's move beyond that now because that's some of the basic things. As a supply chain director, my team is also responsible for pacemakers, for skin tissue that we purchase for a patient that has a severe burn and needs to have emergency surgery, for all of the accessories used in robotic surgeries as well, for grafts and stents and meshes that are used throughout all different sorts of vascular cases. And to give everyone those numbers, to give a number, my team, on a daily basis, is managing 15 to 20,000 case-dependent, unique supplies. To take you through my day, fundamentally, I have 135 wonderful human beings who are responsible for all elements of supply reordering, replenishment, distribution, logistics, triaging, back orders, and really, anything disposable, and some reusable, but mostly disposable that's used on a patient is touching a member of our team. So as I'm sure you can imagine, as I'm sure anyone who's familiar with the hospital can imagine, as I'm sure anyone who's not familiar with the hospital can imagine, the role itself, it's quite impactful.’’ 08:52 Caring for patients with complex healthcare needs Randy said that caring for patients with complicated illnesses was the primary challenge. ‘’But I think the primary challenge that we have, that we will have as an academic institution, is we're seeing patients with the most complicated illnesses and diseases that require, although state-of-the-art and groundbreaking, the most complicated treatments and the most complicated processes and procedures to care successfully for these patients. Of course, fundamentally, in a hospital setting, you're never going to be 100% ever. You're never going to cure anyone 100%. Sometimes care is more important than the cure itself. But putting that aside, I think we're what they call a tertiary coronary academic medical center, which means that we encounter the sickest patients in the world that come to us. So I think the first challenge is we are caring for humans who have very complicated illnesses and diseases.’’ 11:43 Challenges in retaining and growing talent Randy said he expects to lose up to 40% of his experienced team members in the next five years. ‘’From my direct lens internally, I think the main challenge is retaining talent and growing the talent. I say that from two lenses, I'll say that from the lens of 30 to 40% of my team members are within five years of retirement, 30 to 40% are within the first five years of their career. I think there's a gap. And we're noticing, universally, putting aside the supply chain...

A focus on frontline innovation has kept VIE Healthcare at the forefront of hospital cost savings for 25 years. Lisa Miller shares her formula for success with Jim Cagliostro. Episode Introduction Lisa outlines how getting to the line-item details in purchased services was the key to early success, the ‘what-if’ questions that led to patents, and why hospitals should never settle for 10% in savings when digging deeper might lead to 25%. She also explains why letting the data speak takes the emotion out of vendor meetings, and why hospitals need to work with companies that will ‘’run after every dollar’’ of cost savings. Show Topics 25 years of adapting to change in healthcare Paying attention to detail and a focus on data Cost savings innovation comes from ‘’what-if’’? Hospitals have one shot at cost savings Allowing the data to speak at contract renewal A comprehensive cost-savings solution with SpendMend 03:50 25 years of adapting to change in healthcare Lisa said VIE had focused on finding cost savings in purchased services from the beginning. ‘’25 years ago, I knew I wanted to be different. So the difference was, for me, that we would go into an AP department and we would copy invoices. So we literally would say, we don't need anything from your team. We're not going to be disruptive. We're going to go in, we're going to copy invoices, and then from those copying invoices and copying the contracts, we're going to find cost savings. So you won't even see us. We're going to, in the back room, get the data and we're going to come back to you. And that works great. I felt like that was a big differentiator because working with the CFOs and the COOs are like, "Really?" And I'm like, "Yeah, just give me a day, give me two days, we'll bring a couple of people in, and then within less than two, three weeks, we're going to already have opportunities." So that was, in my mind, the least amount of friction that we could get to working with the C-suite, and that, for them, too, they can get buy-in. Obviously, they have to task their team with this. So the most they would have to do is tell somebody in accounting, they're going to be onsite and they're going to copy invoices and contracts. That was the worst case scenario. …. So what happened is, accidentally, because we copied all the invoices, we were 24 or five years ago already started to look at purchase services because others in this space, other consulting firms would ask for a PO detail report and they would focus on that PO detail report for their cost savings. So the purchase services would come up as just the header data and a total spend… they would never even look at it.’ 07:08 Paying attention to detail and a focus on data Lisa said a desire to do the work and getting down to line-item details are two differentiators for VIE. ‘’…we are so detailed-focused, and so when you asked your initial question how we see change or how I view that, it started with how do we support hospitals for success? And so my lens on it was always to make things easy to... be easy to work with, get the data. And then over time, as people saw, like what you said, just our desire, our roll up your sleeves, we get to the details approach. We're not looking at ratios. In the past, we've achieved 7%, so we are going to give you 7% savings. It was always about their data, their line-items, their detail. When we show an opportunity report, it is down to the details. And so that's a great point. That's our differentiation. So fast-forward, we would get the invoices. We had a team of people on the backend just entering line on details. And so our work was always so different, when our hospitals saw that work, like, this is work that we've never seen before. And it's because everything matters, those details matter.’’ 08:22 Cost-savings innovation comes from ‘’what-if’’? Lisa explained how ‘’what-if’’ questions resulted in innovation (and patents) in cost savings. ‘’It's...

Healthcare is in a time of radical and rapid change. Alan Weiss explains to Lisa Miller why coaching is a sign of strength and how all healthcare leaders can benefit from it in an ‘’age of great transition.’’ Episode Introduction Alan explains why the best time to start something is always now, and how the most successful people in every field of life engage a coach to help them achieve their goals. He also explains why there are only ‘’new realities’’, rather than a ‘’new normal’’, why innovation has to come from the frontline, and shares his predictions for the healthcare sector in 2024. Show Topics ‘’If you want to start something, do it’’ There are only ‘’new realities,’’ not a ‘’new normal’’ Coaching is a sign of strength Private sector versus healthcare: one key difference Innovation has to come from the front line The top three skills for successful leadership Healthcare predictions for 2024 02:58 ‘’If you want to start something, do it’’ Alan said the key to success is resilience and agility, not waiting for all the information you need. ‘’Well, if you want to start something, do it. Because nobody has all the information they need before they begin. I've been consulting for 35 years with Fortune 500 companies, and then, as you said, with consultants and entrepreneurs around the world. And I've never started with all the information I'd like to have. And even the information you start with that seemed perfectly helpful, turns out to be either untrue or it shifts or some new development occurs. So the first thing is if you want to start, just start, and have the confidence in yourself that you can be light on your feet and adjust to the times. The second thing is that even if you think you have a long-term project, you still have to start today. And so I've written 60 some odd books and they're in 15 languages. But I've never said to myself, "Well, I'm going to create a book next year. I have a publishing contract and I have a deadline." If I get a publishing contract and the deadline, I start writing the book now. And so there's no time like now. And there's no time like the present, is the old hackney phrase, but the fact is it's true. And the fact is the key isn't having everything you need to start, the key is resilience and agility as you move forward.’’ 05:46 There are only ‘’new realities,’’ not a ‘’new normal’’ Alan said today’s leaders need coaching to make clear discriminations in an age of great transition. ‘’….. There's no return to normal. There's no new normal. What you have are new realities. And the new realities are going to change every day. We're in an age now of great transition. We invent things more rapidly than we can intelligently use them. Nobody really knows about ChatGPT. There are some people lined up out there behind Chicken Little waiting for the sky to fall. We're all going to be eliminated by AI. And of course that's ludicrous. But we do have to understand what's effective for us or what isn't, so what leaders have to do is decide. And this requires discrimination. It requires a clarity of purpose. What is appropriate for their organizations and what is not? For example, I'm on a computer right now with you. And I probably use 20% of this max capability, 20%, but to 100% effectiveness. The other 80%, I don't care. My iPhone here can edit movies, for God's sake. I'm not ever going to edit a movie. But I am going to take pictures. So we have to decide as leaders, what is best for our organization? What's best for us? And that's no easy job. And that's why people need coaching. And they don't need technical coaching. They're not going to delve into the innards of a computer or code. What they need is coaching about their profession and about their own capacities so that they can make these clear discriminations about what is best for them personally and what's not.’’ 08:42 Coaching is a sign of strength Alan said people who reject coaching are generally...