Driving Routine Excellence in Healthcare: The Pancake Syrup Model

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*Please note this transcript is not edited
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Ken Segel - Value Capture (he/him/his): Welcome listeners. I'm ken, Siegel. I'm the CEO of value capture, and I'm pretty excited about this edition of habitual excellence.

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Ken Segel - Value Capture (he/him/his): We're really blessed to be joined by Ronnie Dave's who helps lead. Prisma health Baptist part rich. He does lead it

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Ken Segel - Value Capture (he/him/his): together with a extended leadership team that. We learn a lot from

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Ken Segel - Value Capture (he/him/his): Ronnie. Thanks

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Ken Segel - Value Capture (he/him/his): for coming on habitual excellence with us.

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Ronnie Daves: Yup, happy to be here today.

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Ken Segel - Value Capture (he/him/his): Yeah, we're glad to have you. And we have you here to really 0 in eventually on a really powerful model. You all are honing

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Ken Segel - Value Capture (he/him/his): to deliver healthcare in a way that delivers pretty dramatic great results across the board for the people we're serving as patients. The populations we serve, but also the people providing the care

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Ken Segel - Value Capture (he/him/his): not to mention the financial sustainability of the enterprise. And

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Ken Segel - Value Capture (he/him/his): one of the ways you've caught our attention with it is by referring to it in some ways as a pancake syrup model. So we'll use that as a little bit of a teaser for audience members who may not have heard that.

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Ken Segel - Value Capture (he/him/his): But we wanna back up to start and learn a little bit about you. So how did you get to be a healthcare leader. What kind of environments did you come up in, and what brought you to leadership at prisma? Health?

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Ken Segel - Value Capture (he/him/his): Fifth.

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Ronnie Daves: So yeah, I kinda have an interesting a pathway. I was a biology and chemistry undergrad, and actually became a radioactive chemist for about 8 years, but always had interest in healthcare, you know, originally thought about being a position, but knew that I was a little more business minded, and and just like to go to work. And, you know, going to school for 8 or 12 years just wasn't something that I was really interested in. And so I wound up getting a a masters in health administration from the Medical University of South Carolina, down in Charleston.

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Ronnie Daves: and then, you know, kind of jumped into that in 2,007. So I haven't been in healthcare for very long. But spent 12 years with a community health systems a very large for profit, publicly traded organization, and wound up being a leader with them in 5 different locations CEO, at 3 locations over those 12 years, and then had the opportunity to come back home, which is South Carolina.

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Ronnie Daves: That organization at 1 point owned hospitals in South Carolina, but sold them all. And so prisma health, being the largest healthcare provider in the State of South Carolina, was something that really under interest me in allowing me to come home and be close to family. My parents and my wife's parents. While also, getting to, you know, lead an impact on the State and have some opportunities amongst the State. Right? I am currently in the Midlands Market

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Ronnie Daves: in the Irmo location at Parkridge, which is a 76 bed facility. We just celebrated our 10 year anniversary. So it is a a beautiful boutique nice, and fancy we've got some water water features and a fire feature and things like that. And it really just focused on trying to take the best care of patients as we can. In this Irmo market of the Midlands.

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Ken Segel - Value Capture (he/him/his): And and you certainly have. We'll we'll we'll lay another little teaser here. Your location with your leadership, and then of your colleagues has attained leap product top hospital 3 times together with other fabulous metrics. So we'll get to hear about that.

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Ken Segel - Value Capture (he/him/his): So I think anybody hearing you, just, you know, very briefly and humbly. Go over your your your bio there as a leader.

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Ken Segel - Value Capture (he/him/his): you know. First of all, certainly resonate with

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Ken Segel - Value Capture (he/him/his): you know your commitment to the community and coming home, and all of that, but also

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Ken Segel - Value Capture (he/him/his): you've worked in for profit as well as now, nonprofit, and to have been at in healthcare for and healthcare, you know, for 13 years, and to have served as CEO in so many different contexts already, will recognize a fast riser. Right? So

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Ken Segel - Value Capture (he/him/his): it again. It's great to have you on and and have you share your learnings with us as a leader. So, Ronnie, will you. So so you

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Ken Segel - Value Capture (he/him/his): you were in environments for more than a decade of a certain type. And then you came to prisma. And you guys have started to run a model that's a little different. And you guys sometimes call it pancake syrup.

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Ken Segel - Value Capture (he/him/his): And so can you start by, we're gonna start by sort of having you describe what it is, what the model is from the perspective of a leader. Can you start with sort of the framework, the leadership framework, the philosophy behind it, and then we'll sort of get progressively into how it actually works in a concrete sense.

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Ronnie Daves: Yeah, yeah, I think so. Again, I think you know, Christmas mission is to inspire health, serve with compassion and be the difference. And I think that we do have a model here that we truly believe that we can try qualitative measures by like taking better care of patients than a lot of our counterparts by focusing on pancakes are. And we're talking about healthcare, right? So what does pancake serve have to do with healthcare in general at all.

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Ronnie Daves: But it goes back down to doing routine things routinely well. And again, you, one of you guys, is catch phrases, habitual excellence, right? And so that is doing the same thing each and every day having standard work that drives metrics in the direction that we want to go. And so for us it is those qualitative measures right? And so in healthcare. We all know that every day that you stay here you've got a chance of getting something that's unplanned.

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Ronnie Daves: right a caudie, a collaby, a pressure injury, or something that you didn't come in for. And so we focus on routine things being done routinely well, so that we can give time back to providers, nurses, respiratory therapists people that work within our organization that have a special skill set. Whether that's an education or certification or a competency.

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Ronnie Daves: and we want to make sure that they have all the time in the world to do their special things. We all know that to take good care of

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Ronnie Daves: to not have colleagues. We wanna make sure that we're paying attention to cafetors. How long they stay in, why they're in. And if they need to remain in. And the only people that can make those decisions are providers and nurses. Right? So if we can focus on things and make sure that the nurse gets to spend their entire day focused on cottie care. We will have better outcomes, and we start that. And one of the conversations that we start that with

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Ronnie Daves: is pancakes, or right? So this is 76 bed facility. I think we have 68 patients in our hospital today. So this morning we delivered 68 breakfast trays.

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Ronnie Daves: And if we served pancakes today, you know, hopefully, there's pancakes. Hopefully, maybe there's some bacon. There's cup of coffee and some butter, and probably some pancakes, sir, and if we have forgotten that pancakes are up today, the first thing that that patient is gonna do is they're gonna grab this little, this little thing on a string that's in their bed, and they're gonna push this button and it's gonna turn a light on in the hallway, and it's gonna ring somebody at the nurse's station, and they're gonna say.

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Ronnie Daves: yes, Miss Smith, you know. What can we do for you? And Miss Smith is? Gonna say, I'm super excited to eat my breakfast. It looks great. But I would really like some pancakes, sir.

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Ronnie Daves: and for the next 1020, maybe even 30 min. A nurse is going to go look in the nursement room for pancake Serp, and if it's not there, she's gonna have to call down to dietary to try to find this. And so for the next 20 to 30 min this nurse is not doing something that she is highly trained for, that she is compassionate and engaged about. But she's gonna do something that we have hired

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Ronnie Daves: dieticians and dietary staff to do for us right? And so we focus on that each and every day in numerous metrics, so that the people that do the special things here in this hospital get to focus on that, and they don't wind up wasting their time. Looking for pancakes, or maybe looking for a 2 by 2 in the supply room, or possibly trying to find a medication in the Omni cell.

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Ronnie Daves: And so that's where we focus and and the transition. And the difference from what I've seen at this organization prior to my for profit is, we track a lot of the same metrics right? Even even in all of my history. We've looked at how quick it takes to turn over a room.

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Ronnie Daves: but we've never driven it or tied it to how it is part of the qualitative measure. Right? And so again, you know, the quicker we turn over a room, the quicker somebody comes out of the er the the shorter that length of stay is, and they get on a plan of care so that they can get better quickly. And so I think that's the biggest change is that we continue to focus on routine things that we believe really do give time back to the the heroes and the specialized caretakers that we have in our building.

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Ken Segel - Value Capture (he/him/his): So Ronnie, that is like graduate school in 45 s. Right? And it's graduate school from leaders who have learned to make things clear and simple, right, which we all know is sort of the hardest thing. So let me let me engage you a little bit more about the model, and and and make sure some of the things you said are heard and and checking back with you.

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Ken Segel - Value Capture (he/him/his): So the first thing I heard was, it's really anchored in the vision of prisma to provide the best care it is possible to provide.

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Ken Segel - Value Capture (he/him/his): and

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Ken Segel - Value Capture (he/him/his): anchored in safety like you. Your first example. There was.

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Ken Segel - Value Capture (he/him/his): The longer you're and we're talking about inpatient flows here for your example. The longer you're in here, the more chance you have of getting something

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Ken Segel - Value Capture (he/him/his): bad, right? So it's really rooted in the vision of excellence, and how to get there starting with safety. If I heard you right.

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Ronnie Daves: 100%. And again, I think I think, for profits, talk about quality measures and safety be at the forefront. But again, sometimes the focus still winds up, leaning on the financial side. This is the first organization that I do. We believe that we are truly leading from a staff and patient safety standpoint. Right? We've got to take care of our staff and our patients on both sides, and and that's in some accountability on on either side. Right? Patients also have to take care of our staff and not abuse them.

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Ronnie Daves: We've got that going on the healthcare today. But yeah, every meeting that we have, we start off with patient stories, we start off with great catches, and we start off with any employee injuries that we have, and that is the core of where we start anything that we do, and then from there we try to get into metrics that drive time to providers so that they can take better care of our patients.

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Ken Segel - Value Capture (he/him/his): Right? Okay, so great. So that so then you've outlined this

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Ken Segel - Value Capture (he/him/his): that your focus is on the people who actually take care of patients and doing the things only they can do. We want them doing that 100% of the time, you know

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Ken Segel - Value Capture (he/him/his): that they

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Ken Segel - Value Capture (he/him/his): that's what they do. And they're the ones that can produce improved health and prevent the bodies and all of that. And then this idea of time

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Ken Segel - Value Capture (he/him/his): and that's what you're focused on giving it back to them. And

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Ken Segel - Value Capture (he/him/his): you know, I know when we work with an organization and we sort of help people get to the front line and a lot of leaders and healthcare, and not just for profit. But other organizations are, you know, looking at a lot of numbers, but having sometimes problems getting into the flows and really seeing what's happening.

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Ken Segel - Value Capture (he/him/his): we'll see those frontline caregivers and everybody else spending at least 50% of their time chasing around after 2 by twos and things like that that you're saying.

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Ken Segel - Value Capture (he/him/his): And so you guys are focused relentlessly on that waste elimination in a very concrete way. Did I hear that right?

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Ronnie Daves: Yeah, E, exactly. And and again, every day we have a scorecard that goes out at the end of the day. That talks about the day prior, and it focuses on how long it took us to clean a room and turn over a room it focuses on those supplies being in the right spot. The Meds, being in the right spot, talks about how how quickly the labs were on the chart. Right? And so again, those are. Those are measured each and every day, and they are put on a stoplight report right green, yellow, or red.

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Ronnie Daves: and if anything is yellow or red the leader knows that they need to put in an explanation of what happened? Where was, where was the outlier? And how can we improve that? And again. It's not a punitive dynamic right? It is a truly can we trend things? Can we understand things? Can we make sure that we tackle this tomorrow. So the the exact same outlier doesn't happen again. And and I think it really has driven what I have seen, especially, you know, compared to

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Ronnie Daves: to my 2 2 experiences is that there is a lot more frontline engagement here. Right? We have done a good job of building a culture and showing the frontline staff. What we're tracking, why, we're tracking, and how important they are to the ultimate mission which is taking great care of our patients and and not is it just that the nurse really did a good job with the catheter care? But you helped in making sure

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Ronnie Daves: that everything that she needed to do that was where it needed to be at the right time at the right place. And so I have seen more engagement in the qualitative measures of this facility by an ebs tech or by dietitian dietary tech than I've ever seen, and even engineering right? If the if the if the fluorescent light bulb above the patient bed is not on, and we don't fix that quickly. That's a distraction for everybody that's trying to do the care. And so they are focused on

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Ronnie Daves: getting to any patient facing work order within 30 min. And our group here is on 100 of the time they get to that right. So if the sink is clogged, or whatever, so those patients still feel like their room is clean. Eds can do their job. I think it goes back. I listen to the podcast. With

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Ronnie Daves: mayor gaine from Pittsburgh. And you know, he said, it's kind of funny that he would say that one of the most important

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Ronnie Daves: products that he watches is the public works, not public safety, right? But again, if the city doesn't run, then you can't be safe. And so the same thing. The hospitals are run. You know, everybody talks about being a doctor being a nurse and that being a wow factor, right? And and you know you go. You work at a healthcare in Institute, and you're in ebs and people go. Oh, okay, you're just a housekeeper, and you're like. It's so much more than that. And I do believe that this model

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Ronnie Daves: drives that and drives some of what historically, within healthcare has seen to be lower level positions within the organization elevate and really bring us all to the same team and it and it's really been awesome to see and awesome to be a part of.

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Ken Segel - Value Capture (he/him/his): And it's so exciting to hear that. And we've gotten a chance to walk with you and see it and observe, and of course, watch the results begin to build.

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Ken Segel - Value Capture (he/him/his): And you know, a lot of organizations again, talk about everybody has value and that kind of thing.

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Ken Segel - Value Capture (he/him/his): But you guys are actually working it every day in a way that has people feel very connected to the flow of care, to the patients. And I, wanna, you know, I think probably people are listening and continuing to wonder. Sort of how is this different from what we do? And you know where there might be focus on metrics like you said everybody focuses on the metrics and

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Ken Segel - Value Capture (he/him/his): but then the tie to the people in the actual flow. And so I wanna draw out a few of those things. So you talked about. You know, these key metrics that are related to getting the people on the front line what they need the sort of workings of the hospital in this case on the inpatient side.

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Ken Segel - Value Capture (he/him/his): And

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Ken Segel - Value Capture (he/him/his): one of the things that's notable to me is you guys don't collect 58 measures on every department as your sort of change and key flow metric. You may have one or 2

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Ken Segel - Value Capture (he/him/his): to help people get this fundamental idea.

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Ken Segel - Value Capture (he/him/his): So you almost have less than others. But they're really linked together. Customer supplier flow across the enterprise. Is that an accurate description? And do you want to say anything about that.

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Ronnie Daves: Yeah, I yeah, I think it is exactly that right now. Now, I on a on a true leadership standpoint with with the leader. Right. We've got a lot more metrics right? But when you think about you know

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Ronnie Daves: just right now, from an or standpoint, our metric is first case on time starts right? And and so, from a daily standpoint, that is what we have flagged as one of our key metrics within the, or to have an efficient day. Right? Let's start on time. Make sure our physicians are here. The patients are prepped and all that kind of stuff. And so that's just that one measure for the or

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Ronnie Daves: now, when I meet with that or leadership we talk about, you know a hundred things. But that's leadership. And so these these metrics, I think, are something that the team can tackle right? And they can say, we're really focused on first case, on time starts. And we wanna make sure that our turnover times are quick, right? And so I think I do think it is

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Ronnie Daves: simple, right? And I think I've said this before, too. It's so simple. It's kind of stupid sometimes. That it's just.

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Ronnie Daves: It's the same metrics that everybody's tracking, but it's being delivered in a different model. It is being explained to frontline Staff in a different way. Not just

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Ronnie Daves: we. We. We know that the standard in the industry is a 30 min turnover time, and we want you to do your job right. It is truly that if you do your job, this is what it leads to. This is what it allows your other teammates outside of your unit to do that really drives patient experience and patient care right? Both things.

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Ken Segel - Value Capture (he/him/his): Awesome.

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Ken Segel - Value Capture (he/him/his): And

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Ken Segel - Value Capture (he/him/his): another thing, you know, maybe to illustrate this further

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Ken Segel - Value Capture (he/him/his): talk about

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Ken Segel - Value Capture (he/him/his): how you guys review these metrics as a leadership team every day and sort of first cup stack at the beginning of the day. Give, give! How does what does that look like.

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Ronnie Daves: Yeah, so yeah, I think you know, every day we start off with, you know, an Aod report, an a administrator on duty report that says, this is how many patients are in the building. This is, you know how many transfers we had er volume things like that.

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Ronnie Daves: And then it. It ties to the report from the end of the day yesterday, right? And any challenges that we might have had. And so again, yeah, before I mean usually, while I'm brushing my teeth, I'm looking at the Aod report in my bathroom, and seeing what the day looks like, it's teed up for now I am specifically the person that does the daily scorecard at the end of the day. So I already know what we did yesterday. I know how many things were green.

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Ronnie Daves: I know how many things were yellow or red and and might remember that maybe we had a staffing concern yesterday in in dietary, and I'm hoping that we don't have it today. Right? And so that's how my day starts. And again, like I said, I'm I'm

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Ronnie Daves: I look at the Aod report on my phone, usually while I'm brushing my teeth so I could be ready. And and if there's anything that is, you know, from an overnight standpoint a little bit more important. We can tackle it as soon as possible. But those metrics we look at all of our transfers right to make sure that the the patients that came in our our building makes sense, and that the patients that left our building makes sense right? We wanna make sure. That we? Because again, I think we take amazing care of all of our patients, and so I don't want anybody to go somewhere else

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Ronnie Daves: else that we could have taken care of. And so we track that stuff too.

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Ken Segel - Value Capture (he/him/his): Right. You track the flow of the whole enterprise. And again, if someone has gotten to observe it.

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Ken Segel - Value Capture (he/him/his): one of the things I think is notable, and I want to check this back with you is, and you're checking these pancakes here at metrics.

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Ken Segel - Value Capture (he/him/his): So, for example, pharmacy.

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Ken Segel - Value Capture (he/him/his): if there are any stock outs to any of the floors like heading for 0 as the goal

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Ken Segel - Value Capture (he/him/his): we're root, causing that we are working on that. It is called out. Everybody sees it, and we wanna know why, and we're working on it every day so that the flow of care can continue to those patients unimpeded. And we're getting better and better in our process. Excellence in that horizontal way is that, did I see that correctly when I was there?

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Ronnie Daves: A 100%. And I and I think it's funny with with you talking about medication stock outs, especially right like we've got some some groups that are

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Ronnie Daves: hard core about it. We've got some groups, all do good jobs right. But even our pharmacy group, just in the last, probably about a year ago, I mean, they were down to like 3 stock outs a night right?

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Ronnie Daves: And they still are so engaged that they found another process. They changed, how they came in. They started checking stuff in a different method, and they've driven it down to almost less than one stock out every day, right? And so I think the engagement in that in the in the watching trend lines, right? Because every every month we take the trended data

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Ronnie Daves: to a leadership connection where our entire leadership team sees it. And so you could see, even if you're hitting your goal, you can see if you're creeping up, or if you're creeping down, and everybody wants to continue to creep down to that 0 or up to that 100 right? Whichever metric you're kind of looking at. And it was neat to see that I didn't go to the pharmacy leadership and say, What can we do to drive this down? Because they were doing great right. And I think it goes back to it's kind of that polynomial pro approach. Right? 99% is great. It really is right. 99.5 is great.

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Ronnie Daves: But when we're talking about healthcare, that what that 1% is, a person that 1% might be 3 people depending on your volume right? And so, just because 99% is good doesn't mean that we can't strap for 0. You know, I mean, 0 harm has been on the docket, you know, ever since I came into healthcare, and when we first started, you know, it's like we're not industries right? It's not a widget. Every pneumonia is not the same.

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Ronnie Daves: and so we've had lots of excuses, and there are numerous moving parts. But I do think if you continue to strive and continue to look at things on the individual basis and not just the Stat.

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Ronnie Daves: I think it keeps everybody engaged, because again, we have gone

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Ronnie Daves: 2 years without a Pepsi here we've gone over a year without a caudie here we've got some great scores. But, man, when that one happens it breaks our heart because we know that it was a person we know that it was somebody's grandmother or mother or sister, and and that's just not something that we want to have here. And so we've we've really done some awesome things here, and have gone some really long stretches without harm. And so when it does happen, man, it. It shakes us to our core. And it's something that we need. Right? Because again, you know,

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Ronnie Daves: you can get lack of basically, when things are going really well. And and the only way that you stay at the top is to just truly drive that standard work each and every day.

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Ken Segel - Value Capture (he/him/his): Ronnie, I I love hearing you talk, and you know in this last bit again, what I hear is.

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Ken Segel - Value Capture (he/him/his): that's sort of

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Ken Segel - Value Capture (he/him/his): You know the voice of the staff and the you know, the leaders of the departments and the line staff coming up feeling

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Ken Segel - Value Capture (he/him/his): finally, we have leaders, perhaps, that instead of raining down 500 different initiatives and things kind of vertically on us, are supporting the actual flow of care that we're here to provide and helping us become great problem solvers and innovators to do that, and the pride that comes with being supported in your work and being able to be very, very successful right and sort of in a system that

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Ken Segel - Value Capture (he/him/his): you know we hear all day long about systems where people are pulled 50 different directions, and are sort of overwhelmed by various different things, not pulling the same way. And you guys seem to be pulling the same way around the actual flow of care am I? Is that the goal.

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Ronnie Daves: Yeah, I yeah, I believe so. And again, as a market, we 100% are right. All there's 4 hospitals in this market. Mike Bundy is over all of them. And is our leader and champion of this, and and we treat it as a thousand bed hospital. We all have the same metrics. We all have the same standards. We're all working towards the same thing. And then I do think, as a global organization, we've got some good pi stuff. And I think we continue to engage those leaders and say.

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Ronnie Daves: you and your team find something that's beneficial to you. Right? That does impact a patient, because just us looking at some stats or finding some number that we think is out of whack

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Ronnie Daves: and pushing that agenda on, somebody doesn't let them own it. And so I do think we also do a good job of of engaging our group to say what would make you like your job better? Right? What would make you take better care of patients and and and you go find that we just. I just left one of those meetings. Right before coming on this. And it it was neat to see the respiratory therapy group say, we want to focus on under 37 week deliveries, because I think

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Ronnie Daves: we don't get invited all the time. But we want to be there for that baby every single time, right.

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Ken Segel - Value Capture (he/him/his): That that that's excellent, and thanks for mentioning the you know, prism is a very large system, and the good work of the large system. For those that don't know. Prism is being recognized increasingly as a leader and creating a sort of unified operating system to support the front line, including very sophisticated.

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Ken Segel - Value Capture (he/him/his): well organized, simplified flows of clinical information and support to the front line. So very in keeping with sort of this incredible leadership and operations model that you're sort of bringing to bear very intensely in the Midlands market. So that that's that's great to hear. Let's

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Ken Segel - Value Capture (he/him/his): there's so much to talk about here.

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Ken Segel - Value Capture (he/him/his): Let's talk a little bit about results, right? Cause everybody. It's a stress time in healthcare. Everybody knows we need results. Can you share a little bit about once you've got this organized and flowing, and the people are buying in at every level. And you know, obviously, you're bought in. We can feel your energy. What results have you all produced? With this over time? And and how how do you think about it? As a leader in terms of the results it's capable of producing.

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Ronnie Daves: Well, I mean, and again, specifically for Parkridge. Yeah, we're a leap frog, a hospital 7 out of the 8 last reporting periods. We've been a top hospital 3 times. So qualitatively, we're Cms 4 star, that kind of stuff so qualitatively. I think we've done great one of the things I think that is really neat in the last, probably year and a half

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Ronnie Daves: is how we have scaled this across the market right? So mike started at Baptist and Parkridge, 2 of the hospitals. He's now over the other 2, and so to me and Richland are now coming along, and some of the things that we've done just over the last year is really neat. We've we've gone from 40,000 discharges across the market to 44. So we've come up almost 10,

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Ronnie Daves: and and while seeing a reduction in our length of stay from 6.6 days to 5.9, so across that many people, and that many locations driving that length of stay down is just very, very impressive.

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Ronnie Daves: We've grown in our er volume by about 38%, and we've reduced our length of stay there right? And and while growing almost 38% in the er we've reduced our left without being seen from 4 and a half to one and a half percent right? And it's and it's in those metrics that we drive and the things that we pay attention to. Right it is. It's the turnaround time of the bed that people aren't just stacking up in the er

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Ronnie Daves: but we empty the room upstairs, and we get a patient from the er we move them upstairs, and another person gets to come in and get seen by a physician quick enough that they don't leave without being treated or seen.

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Ronnie Daves: and so I do think there has been some just awesome things there. specifically, again, with Parkridge. From a

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Ronnie Daves: mortality standpoint, and a psi, 90 score. We're in a 90 fifth percentile. So we do better than 95% of the hospitals in America. On those metrics. We've got lots of nineties and 95 S. And stuff. And so it is a safe place to come. Get care right? I mean, it's it's always good to to work in a place that you're happy to, you know. Invite your family, invite your friends and say, Yeah, I wouldn't go anywhere else. But it is really neat

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Ronnie Daves: to see the things that we're doing as a market, and how that we also strategically have conversations about getting patients in the right locations based on the volumes that we do right again in healthcare repetition is good, you know. The more the more you do of something, the better you get at it. And so just driving those dynamics. And then some of our financial turnarounds from last year to this year have been

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Ronnie Daves: dramatic, more in some of the downtown places than Parkridge. Parkridge is in a very good pair, mix growing community, and so financially we do. We're pretty strong here, and and usually carry a decent amount of weight. But the the other financial dynamics that we have done has just been impressive, because again, 44,004, 1010% more discharges with a lower length of stay. That's always a good thing.

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Ken Segel - Value Capture (he/him/his): And this led to

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Ken Segel - Value Capture (he/him/his): toward a hundred 1 million dollar turnaround in a couple of campuses, etc. So you know it. The leaders listening, won't be surprised that the financial numbers have been significant. But you know, because you produce the operational change supported, and you know where the people are energized by it. Right? Cause it's sort of organized the right way.

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Ken Segel - Value Capture (he/him/his): That's it's exciting to see all those, and we like to talk about win win wins at the same time, like the good things happening at the same time, because you're running a great operating system right?

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Ken Segel - Value Capture (he/him/his): And I'd like to emphasize that point, too, because and I don't know if you hit this in earlier in your career. But a lot of healthcare we still see organized as there's the management system over here.

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Ken Segel - Value Capture (he/him/his): There's the quality system over here. There's the safety system over here. The Pi team may be even separate from that.

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Ken Segel - Value Capture (he/him/his): You guys are running one system

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Ken Segel - Value Capture (he/him/his): that embeds all of that.

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Ken Segel - Value Capture (he/him/his): Is that a fair? Is that a fair statement of your goal? And what's actually happening.

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Ronnie Daves: It it is, and and and the pulse system is available to all frontline staff. Right? I mean, it is a learning. It is a learning platform. Right? It is. It is the place that we want to enter everything so that trends are built across the system right? Not just this facility, but all of the facilities. It is a. It is a learning mechanism, so that our frontline staff can put in

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Ronnie Daves: things that almost happened right. Great catches, good, catches, things that like I saw this Med, and it was in the wrong spot. And and if that gets plugged into the system 2 or 3 times. We know we have a system wide issue, right? And so we may. Partridge may save the life of somebody in Greenville, South Carolina 2 h away because of the

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Ronnie Daves: engagement that we have. And again, I think we are trying to push a culture of

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Ronnie Daves: self reporting. And and you know, not to say tattle it on yourself, but like you're not in trouble, let's fix these things right. We can't fix the things that we don't know, and if we just fix them and don't tell anybody else, we will miss those systematic dynamics. And so I do think.

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Ronnie Daves: as we work together, we will drive the quality across. You know the entire State of South Carolina, and I think that's been seen. You know. Prism. Health was was formed almost a little more than 5 years ago. South Carolina used to be like 40 Fifth in the nation for healthcare outcomes. We're up to 38 now, and we are the largest healthcare provider. And so I do believe that we, as an organization, are truly impacting the entire State of South Carolina

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Ronnie Daves: and the help outcomes that we have. And there are numerous spots. I mean, yeah, Mike is focused on a Zip code in the Columbia market that's got more diabetic amputations than anywhere in the nation. And and and that's the organization that we are right. And and I think all of these operational qualitative measures that we do, and the improvements that we make, allow us to have the the quality

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Ronnie Daves: to take care of them, but also the financial wherewithal to do a little bit more outreach right? A little more reach to maybe a patient population that doesn't have the money to to do all the things that they need to preventively. And so it is exciting that as we continue to turn the corner financially as well that we hope to be able to invest in our communities a little bit stronger that we have in the past.

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Ken Segel - Value Capture (he/him/his): It's so great. And you know, thank you so much for talking about that upstream stuff, too, because it's the same thinking, right when you're thinking systemically in the flow of value. How, how, how early can we get this and help people protect their health so they may not even have to come here and to see prisma making that kind of difference across the State that's measurable with these ideas is really exciting at a at a challenging time, I think, in a healthcare. So it's exciting. It's it's really exciting to hear that.

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Ken Segel - Value Capture (he/him/his): And I I just want to make the point to listeners to from the process, improvement, community, etc, and from the leadership community.

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Ken Segel - Value Capture (he/him/his): You all are running a single system where you root cause a safety problem the same way you root cause an operational problem, and you're doing them both in real time that day. And you're looking at them together. And you're using the same method, and you're creating excellence in the same way. So this is not a, you know, a tower of battle. This is a this is a highly honed, integrated, simplified commonsense system, and it's exciting to see it working.

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Ken Segel - Value Capture (he/him/his): So.

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Ken Segel - Value Capture (he/him/his): Ronnie, will you talk here in this next section a little bit about this method. And and you your group as a leader, your your leadership group. And you guys working together on this

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Ken Segel - Value Capture (he/him/his): with your peers and what it's done for you as a leader. How has it helped you evolve as a leader? What have you learned.

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Ronnie Daves: I I mean, I think the biggest thing is, it's really just re-engaged me right again. I I work for a for profit organization, made it, you know, a couple of years into Covid. And and again, I think the focus on trying to be financially strong during a tough you know, social dynamic

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Ronnie Daves: was leading towards Burnout right was leading towards a spot where I I felt like the number. One focus was to the, you know, make another dollar. That was what was the number one fact factor at the moment. And so coming here and seeing that engagement and seeing how we have

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Ronnie Daves: energized, and giving everybody in this building. You know a a flag to stake on what we do from a quality standpoint. Has been re-energizing for me if that makes sense. And again, we all we all kind of came into healthcare for healthcare reasons, right? And again, the business model at some point during my career became the bigger focus than actually taking good care of patients and staff

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Ronnie Daves: and so that has probably been the biggest

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Ronnie Daves: enjoyment of this transition is seeing that instead of talking about quality, we really are driving quality right again. Everybody talks about it. And and and there's always some emphasis on it. But I do believe that it is the number one focus of this organization, and that feels good. Right? That takes you back to what is deep down in your heart, and the reason that we've come into healthcare, even if we're not a provider, even if not, I'm not a patient

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Ronnie Daves: facing you know, person, and and for me, I've worked in a lot of rural hospitals, and I've always taken pride in trying to grow organizations from a size standpoint, so that we can be a great employer as well. Right? And so I I enjoy that. And I think it's neat that I have now become in an organization that not only are we going to grow and we are growing, but we're engaging the people that we hire into the core mission of what we do.

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Ronnie Daves: Not just you clean rooms, right? Or you deliver food. It is. You are part of taking care of this community and driving our health space scores up.

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Ken Segel - Value Capture (he/him/his): I think everybody can hear your energy. And again, my hypothesis is, you may be hearing from some of your peers about. How can I get into this organization and get I'd like to recover some of this feeling for myself. So Ronnie, what is what is next for

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Ken Segel - Value Capture (he/him/his): prisma for Baptist Park Ridge and pancakes, Europe, and how you're thinking about these ideas as a leader.

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Ronnie Daves: But I I'm I'm looking forward to the next few years. I've got some kids that are, you know, coming into high school and stuff. So I'm gonna hunker down. You know my my career path. If you if you dig into it or find it, it's been it has been

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Ronnie Daves: pretty progressive and has been in numerous locations pretty quickly. We're gonna we're gonna try to hunker down and and hang out here and really be a part of this progress super excited that. This is a facility that is slated for some growth. It's in a great market. In the Columbia market, so we hope to add some beds and some acuity, and some service lines that we have not been providing here in the near future. But just super excited to continue

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Ronnie Daves: continue to see what we, as Park Ridge us is the Midlands. But then, also, us is just prisma what we're gonna do for the State of Sacramento? And so looking forward to continue to work with Mike. Mike has been an amazing leader and mentor and and he believes in this even more than I do. He's been doing it a little bit longer. But it's been fun, and it's just really neat to see that we have driven. You know there is 4

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Ronnie Daves: 4 hospitals here, about 1,000 beds, and we're all on the same page, right? We're all pulling in the same direction. And we're all focused on the same things. And so

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Ronnie Daves: really excited to see how long we can drive some of these amazing quality measures, because again, at Parkridge we've got some great scores. And so sometimes we're kind of going for some records right like, how long can we do something? Really, really? Well, and so I'm excited. To be here in the market and continue to serve here at Parkridge with just an amazing team. Again. We celebrated 10 years on March nineteenth, so I guess about a month ago, almost

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Ronnie Daves: was the 10 Year celebration. And you know, we've got about 450 fts here, and I think there's still 80 people

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Ronnie Daves: that we're here on day one.

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Ken Segel - Value Capture (he/him/his): Wow!

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Ronnie Daves: And and and through Covid. That's just super duper, impressive, even without Covid, I think that would have been impressive. But to see that we still have that many people that we're here on day one and still believe in this facility so much that they're still here is is pretty pretty awesome.

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Ken Segel - Value Capture (he/him/his): And when you walk around your your sense that a lot of them have the same excitement that you do about what's being achieved. And what can it be achieved? And I know it's been a privilege for us, way back in the day to have worked directly with Mike Bundy, the the leader of the region, as you said

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Ken Segel - Value Capture (he/him/his): and also more recently, to sort of learn with you,

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Ken Segel - Value Capture (he/him/his): and and your peers and and the other leaders at prisma, who are really taking ideas forward, and that, I think, are very important

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Ken Segel - Value Capture (he/him/his): based on the right values based on sound operational thinking, and that kind of simplifying, anchoring and purpose that we all need, and pulling it off to to great effect. So

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Ken Segel - Value Capture (he/him/his): with a I love that you cited that that big time impact on state health already. I mean, that's you know, folks. This is what it's all about, right.

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Ken Segel - Value Capture (he/him/his): Ronnie, thank you so much for being a guest, and let me just ask if other leaders would like to learn more about the model, and and how it's just a little bit different and organized a little different and and from from how they may have been dealing with some of these issues and trying to put together their own leadership system.

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Ken Segel - Value Capture (he/him/his): Is it okay? If, they head your direction with a question or 2, or the request to visit, how how should we handle that.

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Ronnie Daves: Yeah, anytime. Happy to happy to share. What I have learned and what I've continued to learn. Right? I'm I'm still in the infancy of this. And so again, I have enjoyed listening to some of your podcasts that you guys host, and it was really neat to hear the Mayor of Pittsburgh on a different side, right outside of the healthcare dynamic. But but process improvement and

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Ronnie Daves: come into a core mission is it doesn't. It's not a healthcare thing. But yeah, find me on Linkedin. Shoot me an email. Ronnie, Ronnie. Dave's@prismhelp.org and again, you could find me on Linkedin somewhere. Happy to always connect with anybody that's willing to learn, and wants to learn, and or might have something to share with me, so I can continue on.

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Ken Segel - Value Capture (he/him/his): Thank you, Ronnie. It's so generous. And we'll we'll put your contact information in the show notes. And you know, continue thanks to everyone in prisma for being willing to to share the important frontiers you're pushing. And for those that are interested in additional information on the pink picture model and these ideas in general and the philosophy behind him. You can also.

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Ken Segel - Value Capture (he/him/his): as Ronnie alluded to our podcast and other material that can be found through our website at Www. Value capture. llc.com.

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Ken Segel - Value Capture (he/him/his): Ronnie. Thanks for being with us. And and but more than that, thank you for the leadership you're providing to American healthcare and the difference you're making, and I hope, showing the way for others.

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Ronnie Daves: Thank you, sir. Happy to be here enjoying it.

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Ken Segel - Value Capture (he/him/his): Glad that you're here. Thanks a lot.