The Chris Voss Show - The Chris Voss Show Podcast – Stephanie Dorwart, CEO Altius Healthcare

Episode Date: June 27, 2022

Stephanie Dorwart, CEO Altius Healthcare Altiushcg.com

You wanted the best. You've got the best podcast, the hottest podcast in the world. The Chris Voss Show, the preeminent podcast with guests so smart you may experience serious brain bleed. Get ready, get ready, strap yourself in. Keep your hands, arms and legs inside the vehicle at all times. Because you're about to go on a monster education roller coaster with your brain now here's your host chris voss hi folks it's voss here from the chris voss show.com the chris voss show.com hey welcome to the show the big podcast so it's good to have you guys again after 12 years we're always happy to see you once again be sure as always do if you don't subscribe already to all the

different features of the social media on our thing make sure you subscribe to those things youtube.com fortress chris voss or tell your friends and neighbors to subscribe just knock on your neighbor's door when you borrow sugar from them. Does anybody still do that anymore? My mom used to always make me knock on the neighbor's door and go hustling for sugar and baking soda and whatever we were cooking that she was out of. But I think nowadays you can't do that. Otherwise, people, I don't know, they call the cops on you or fire weapons at you, I think. I don't know, man. It's been a long time. Maybe that's a good way. I mean, i don't know man it's been a long time maybe that's a good way i mean i i don't know what the kids are doing these days but you can go to also goodreads.com fortunes chris voss all of our groups on facebook linkedin twitter the big 122 000 linkedin group and our linkedin newsletters

subscribe to that as well that's always fun it's just entertainment as Oh, and also you can go to, we're giving away a couple of these extra EKSTR wallets. And they've got some finders in them too. You can go to Chris Voss, the Chris Voss Show, forward slash giveaway, I believe. And you can find out more about the show. What we're giving in are the giveaway there. Anyway, guys, we have another amazing person on the show. Today we have Stephanie Dorwart on the show. She's the owner of Altius Healthcare Consulting Group, and she focuses her consulting practice

on workforce optimization, productivity, leadership development, and performance implementation. As an architect of successful labor management system, she has worked with hospitals ranging in size from 25 to 900 size beds. Wow, that's a lot of beds. Most recently, she constructed and built content for Virtual Training Academy designed to train healthcare leaders to become the CEO and CFO of their department and cost center. Stephanie serves on the board of Western PA chapter of American College of Healthcare Executives, and she

recently founded a nonprofit called the Valachron Foundation that will provide scholarships to students in the local community. Welcome to the show, Stephanie. How are you? I'm doing great, Chris. Thank you so much for having me today. I'm really excited to join the podcast with you and look forward to sharing some more information with your audience. Thank you. We're excited to have you as well. Give us your dot com so people can find you on the interwebs, please.

Dot com is Altius, A-L-T-I-U-S-H-C-G dot com. And you can find us across all the other social platforms as well on the same moniker. There you go. So give us an overview of what Altius Healthcare Consulting Group does. Absolutely. So Altius Healthcare Consulting Group really focuses on improving the financial performance, operational performance of hospitals and healthcare organizations, Chris. We primarily want to make sure that our clients have the right person in the right place at the right time with the right tools for the right clinical outcome. And healthcare today, as you can imagine, that's a really large challenge. But we really want to focus on making sure that our clients are as efficient as possible, but have the strongest patient outcomes as well. So we do everything

from helping them schedule their patients a little bit better, to ensuring that they have the right level of staff based on the volume of the staff to educating and elevating their leaders so that they actually understand how to manage their individual departments. And it's probably been a wild ride these past few years with trying to place people. I know a lot of nurses and doctors have been moving around the country with COVID and stuff. It has absolutely been a wild ride the last two and a half years. And I think that ride continues for healthcare leaders and healthcare executives and the workforce in general. I think in the beginning, everyone was scattering, trying to figure out how to actually respond to

the pandemic. So there were a lot of stopgap places put in place to actually care for the patients. There were some workforce shortages at that place, some supply disruptions, but everyone was really focused on how can we actually provide care to all the patients that we have. We're now, as we're coming through two and a half years into this, it's a little bit different situation. We're now dealing with workforce shortages where, you know, depending on what statistics you look at, anywhere from one out of every three to one out of every four workforce, the healthcare workforce have left the bedside, meaning that we have staggering shortages across the field. And in other areas, we have shortages with physicians.

There are some issues with travelers where the actual costs have gone up. Supply chains still continue to be an issue. And then if you add on top to that what everyone else is experiencing right now with the escalation with cost, it involves inflationary measures. Hospitals, healthcare organizations are struggling. Yeah, everyone's struggling. Everywhere I go here, I see help wanted signs. And I don't know, I suppose maybe the cooling of the economy is going to affect some of this.

So how long have you been doing this for with your consulting group? Yes, I've been on the healthcare side of the business now for nearly 20 years. Wow. I started out actually as a mathematics teacher. Oh, no. And whenever I was going into school, I was actually aeronautics engineering. And my sophomore year realized that it probably wasn't for me whenever we were doing simulations and my plane crashed. So I figured I better stay on the statistics side of things. I at one point realized I wanted to go back and mirror my initial passion, which I

always wanted to be a pediatrician growing up. I was the youngster that walked around with the stethoscope, took all of my relatives heartbeat, et cetera, and pulse. So I went back to get my master's of healthcare administration. And it was within the first week of working at that organization that I realized I had a passion for productivity and workforce optimization. That hospital had had a reduction in force the week prior to my arrival, where they had to lay off about 200 of their staff members. And unfortunately, they didn't actually have the systems in place to ensure the culture was maintained following that

or the systems in place to make sure they never got back to that situation. A lot of times what happens in healthcare is you make quick and rapid changes, like a reduction in force where you lay off 200 people to only realize you actually needed half of them a couple months later. So I really made it my priority to research everything that I could, put in place the databases and build out the structures to ensure that healthcare organizations had a better way to manage their staffing resources. And why are you so passionate about your mission to help community hospitals? What motivates you to stay in this field? Yeah, that's a great question. I grew up in a small town called New Kensington, Pennsylvania.

It's actually the town where the company Alcoa was founded. So we're responsible for aluminum in the beginning of aluminum. But we had a small hospital in that community called Citizens General Hospital. It's actually the hospital where I was born. And over a series of years and decisions that that organization made and dynamic impacts of organizations moving out of our town, that hospital actually closed. And whenever the hospital shuttered at doors, many of my friends' parents lost their jobs. A lot of the community restaurants had to close down. Many of the downtown businesses shut their doors because there wasn't that infrastructure of the actual hospital, which was one of the largest providers of employees in our town or our largest employers

in our town at the time. So it became really a passion of mine that I really strongly believe that all communities across the country have a right to high quality care and have a right to have a hospital in their community to provide services to them whenever they need that. That's extremely important right now in rural communities as well as other areas. So I'm really passionate about the fact that everyone, regardless of where you live, should have access to care. And one of those pieces is to have a hospital that you're actually able to go to in cases of emergencies. Yeah, I've read over the years, one of the biggest problems rural communities have is they're losing these community hospitals. And COVID, of course, was completely overwhelming for them. And I guess a lot of people, you know, we really fried out our nurses and doctors with

COVID. I mean, I saw, you know, lots of different posts on burnout and different things. And, you know, it kind of reached this point where, you know, so many doctors and nurses were just so sick of the COVID kind of attitudes that were overwhelming. They're just like, take the medicine and just the craziness of it all. So, you know, telemedicine's been a big thing. How has that maybe impacted what you're doing and how you see it coming forward in the future? Telemedicine's a great topic and it plays into rural health a lot. You know, initially,

telemedicine was used very infrequently within the industry and very few patients were actually accessing it. But what's happened with the pandemic is many organizations that did not even have a telemedicine infrastructure had to stand it up overnight. We had clients that had never done one telemedicine or telehealth visit prior to the pandemic, but within a week, about 60% to 70% of their visits were actually done through telehealth. What's happening right now, Chris, as we get to this stage,

you know, telehealth is becoming a big way to actually provide access to specialties in rural communities. For example, maybe you live in a rural community, you actually have to, you know, access a cardiologist, but there's not a cardiologist that's readily available in your local community. Well, through partnerships with large academic medical centers or other tertiary providers, you now can actually have a telehealth visit. And while you're wearing things like, you know, your iWatch and other components of home health, you can actually monitor your health in a better way

and actually have those telehealth visits with the cardiologist without having to get into the car and drive 80 minutes, 90 minutes, you know, 60 miles away to actually get to that appointment. So you have more frequent contact with the specialist and you can actually spread it out. Another way that telehealth is making an extremely large impact right now is in the behavioral health community. I'm not sure, you know, if you've heard at all about how

overwhelmed, you mentioned burnout of the actual clinicians, and that's a big factor. But there's also a larger influx of behavioral health issues coming into emergency departments across the country. And in many cases, the hospital staffs don't have the resources to actually respond to those behavioral health needs. So one way to actually help to kind of stopgap that is to have access to telehealth behavioral health visits. So people that do have anxiety, depression, other components in many cases that have been brought on by the pandemic issues can actually have access to those resources and actually deal with it prior to actually reaching a breaking point. And telehealth is a great way to provide that. You can actually have your telehealth visit in the middle of your workday if you need to over your lunch break or at the end of the day. So it makes it much more accessible to patients across the country. Yeah. I mean, telehealth has saved me quite a few times in

recent memory. There was one or two times where I was so sick with pretty much walking pneumonia that I couldn't get out of bed, but I needed a Zip. And I couldn't drive down to the doctor's. I couldn't even get to the, drive to the clinic. I had somebody drive me to the bed, but I needed a Zip. And I couldn't drive down to the doctors. I couldn't even get to the, drive to the clinic. I had somebody drive me to the clinic, but just I'd sit in bed and the world would spin. And the telehealth saved me. In 2012, I wrote an article with Forbes magazine calling out the need for telehealth. And at the time there wasn't any, I should have invested in and started one. But we had a telehealth doctor on yesterday. It's great that this is coming through and helping rural communities.

I never even thought about rural communities, helping them and everything that they're doing. You guys also do Virtual Training Academy evolved with you guys. And you guys have set one up, I guess, through your guys' portal. How does that work? Yeah, so the Virtual Training Academy

came on as a result of the pandemic, but it was really in the works prior to the pandemic. We were building up what would be, you know, an in-person curriculum where, you know, you do your typical group training that emerged because what we found with our clients when we were going in to do performance improvement is a lot of times in healthcare, we're great at recognizing the strong clinicians and the strong doctors and the strong leaders and promoting them up from the bedside to the management role. But we're not as good at actually providing them with the training and the tools to help them understand what is a budget? How do you build a budget? How do you

manage your budget? What is an FTE? How do you resource that? How do you hire the right individuals and then help them to improve their performance? And so the managers would come into the roles, they have access to all the information they need when they need it. So whether they're dealing with change management or they have to figure out what are the right interview questions to ask an individual, how do you locate the right staff? How do you retain the right workforce? We built that all into our virtual training academy. So we can not only help

our hospitals identify what they need to do to improve operations, but each of their individual managers can improve their skills. So it was really a labor of love where we record out about 120 different segments and each of the managers can go through and earn three different certificates on process improvement, on change management, and just on operations overall. That's pretty awesome. And it's probably needed considering people that have left the system and they probably need more people to move up to the ranks of management for the holes that have been created from people leaving. The great resignation was kind of weird, man. How it all has come out.

I mean, some people left forever. Some people regret switching stuff. I don't know. It's going to be interesting. Any other big changes that you expect are going to occur? You know, I think that there are a lot of disruption that's going to happen in healthcare and a lot of innovation that's occurring. We're seeing a lot of changes happening with AI and artificial components of things happening. I think that's going to continue to evolve. One of the areas that's advancing a lot, of course, is whenever you start to think about oncology and research dealing with all of that. And we've already always had large electronic

health records that are pulling all this information. But historically, there's not really systems that talk to one another. I think that we will see and things in health in a way that protects everyone's privacy, but also allows us to understand what types of treatments are best for what types of patients. And we even saw that with near the pandemic and COVID-19 where certain types of blood types were responding differently to the infections and different patients with comorbidities had different outcomes and different treatments provided different results. But we couldn't do anything with that because it's in 20 different EHRs and systems you can't pull together. And so individual hospitals, individual communities had to rely on their

own research and their own outcomes. I do see that down the road from a public health perspective, we will see all that coming together so that we can access information in a way that can support outcomes and research oriented therapies. That should be pretty interesting. I also think, you know, we all know about Mark Cuban and what he's doing in the pharmaceuticals and, you know, what's happening with some of the other innovation and disruptors. I think we're going to see more and more of that happening. We consistently see more for-profits moving in with CVS, Rite Aid, other components there. That's going to continue to disrupt. You're going to see more companies like what Mark Cuban did with the pharmaceuticals coming in and really trying to cost contain within healthcare. Right now, I think healthcare is a $4.3 trillion industry.

Is that all? So you're dealing with a capitalistic environment and you see $4.3 trillion, more and more people are going to move in to those, try to find ways to actually be profitable in those environments. And out of that $4.3 trillion, it's estimated that roughly $1 trillion of it is waste. Wow. Which means from, you know, you think about that, 25% of every dollar that's being spent on healthcare within the country is estimated to be waste. That waste can come from a variety of areas, administrative complexities, you know, cost complexities and price components of that, but also, you know, care issues, care that maybe was not necessary but provided,

and all that breaks down into roughly $1 trillion of opportunity that I think people are going to try to leverage over time. Yeah. I mean, that's a lot of waste. That's a lot of waste. I guess your estimate's at 25%. Yeah, that's pretty huge. It is. And it was large before the pandemic, and it's just grown since that time. Yeah. Now, you've focused on your career on productivity. How do you define productivity and how is it important, especially in, say, the field you're in with the hospitals and stuff? Productivity is an interesting question. Most of the time when we're brought into hospitals and our clients and they find out that we're the productivity firm

or the work with optimization firm, they're groans and I think people are conception. We're always, I'd say, not the people that are, you know, the welcome mats rolled out for sometimes the executives love to have us there. But I think, you know, productivity by definition is really how much input or how much time does it take for an output? And it's easy for us to define that when we're thinking in terms of manufacturing, how much time is it taking us to produce a car, but it's more difficult when it comes to healthcare. But the way I really view productivity and the way I think about it is we all want to make the best use of the time that we have. And so when you're thinking

about being productive, you're thinking about how can I be the most effective that I can be in the time that I have, whether it's in my personal life and work and just getting through the tasks that I have to work through. So productivity is improving efficiency, but more importantly, productivity to each individual person or hospitals. How can we consistently improve performance so that we can get the most out of the time that we have for whatever we're doing? And so that's really what being productive is. It's really looking at what you're doing and making sure that you can eliminate any of the unnecessary time to produce that result. And that's true for whether it's scheduling a call, whether it's a radiology appointment,

it's operating room, whatever you're doing is how can we actually get the best result possible in the shortest amount of time and the best quality results? There you go. I mean, that's how you eliminate waste is productivity. And yeah, and sometimes it, uh, yeah. And, and sometimes it's just, you know, I imagine sometimes it's just streamlining different things,

right. Making it to streamlining stuff so that it, it, you know, there's less hoops that people have to jump through and everything. Maybe. Yeah, absolutely.

Streamlining processes, eliminating steps. Sometimes it's as simple as making sure that the supplies that someone needs are in the location that they need them, you know, making sure that the bandages are right beside the nurses in the emergency department, instead of the storage closet, you know, down the hallway. It's just little things like that that can actually make a big difference in the outcome that you're looking for. Sometimes it's eliminating reports that someone's still doing that no one's looking at.

There's a lot of waste at a lot of different places. And just taking, you know, a closer lens at that and looking at the steps to the process and looking at what individuals are doing can eliminate a lot of that. Yeah, those TPS reports. What is that movie, Office Space? The TPS reports. We've done our TPS reports. What is that movie, Office Space? The TPS reports. We've done our TPS reports. Yeah, sometimes there can be real issues with, you know, you spend so much time.

You know, I've worked at, well, we worked for a medical facility one time with one of our companies, and my partner worked inside them. They spent so much time writing memos to cover their butts over crappy stuff that was happening around the office they were they're constantly writing memos or emailing to try and cover their butts and make sure that they couldn't get fired for something i think at one point they they had they had put a swipe key on the bathroom door so they could know how long people were in the bathroom it's kind of interesting yeah very interesting you know i think you know one of the scary things too just thinking about tps and office we're all we're sometimes compared to the

bobs but you know one of the scariest things that i see is we'll have executive teams or managers and directors and we'll just ask for a 15 minute slot on their. And they'll say that we can't schedule that for the next eight or nine weeks. The next time that Mr. X is available or Mrs. X is available is nine weeks from now at one o'clock. And there's a 15-minute opportunity where you can actually speak with them. Wow. And if you have that, to know that your entire calendar is fueled from 7 a.m. in the morning until 7 p.m. at night for the next eight to nine weeks, there is no way you can manage a hospital. So I think that's also efficiency is you don't really need a three-hour meeting if you can accomplish that meeting in 45 minutes. Yeah, yeah.

It's, you know, and meetings sometimes can be nightmarish where people just go on and on. And, you know, the Zoom, I've had so many friends that work for big corporations and the Zoom call, so they have to endure every day. They're like, oh, my 20th Zoom call today. Shoot me now. You know, you'll see them talking on Facebook and stuff like that. So it's really interesting. And let's see, anything else we ever talked about that we should talk about what you guys do for hospitals and stuff? I think we've covered a lot of it.

I think the most important thing right now is to just realize that we are going through, you know, some what I consider be unprecedented times. That's absolutely true. You touched upon burnout. You know, I think retaining staff is extremely important currently, making sure that that staff is supported. But you can't really plan for the future if you don't have a plan. I think right now sometimes we're only looking a month ahead or three months ahead. And it's important to make sure that you have a plan in place with your workforce strategy 12 months ahead, two years ahead, three years ahead to manage what you're expecting to happen. So if you don't have a workforce strategic plan or you don't understand how you're going to actually close your staffing shortages or your gaps or reduce your burnout or retain, it's really time to focus on what are your solutions going to be in those areas? I think that's one of the things that we do great is looking at that organizational assessment, identifying the truth of where an organization

currently is, and then putting a plan in place to actually leverage that, help to improve that performance moving forward. You can't really start an improvement process if you don't know where you are today and you don't understand where you have to go in the future. That's very true. Now, on leadership, you know, one of the things you guys do train and help on, what traits do leaders need to have in your mind in order to lead organizations during these turbulent times? Great question. You know, I think one of the traits that's really important right now for leaders to really be very strong at, and it can't be overstated enough, is transparency and communication.

And I think that's extremely important because a lot of times whenever things get tough, we all have a tendency to retreat. And in today's environment, I think it's extremely important to be visible as a leader and to communicate the situation. You know, a lot of times, you know, you're going to be making changes within the organization, but you're not communicating why those changes are necessary. So whether you have to ask staff to cross train across departments or ask someone to move into a different position or a different role or just do things differently, you have to communicate why that's important. If you can communicate why it's important. If you can communicate why

it's important, you can actually leverage that and then help to get everyone else on the track with why you have to change and then show them the plan for how. Sometimes we tell people what we're going to do and where we're going, but we don't give confidence that we actually know how we're going to get to the other side. So I think communicating and actually being transparent and then being visible is extremely important. But I tell people right now that do not be afraid of change. We have to really embrace the change and push through where we might be comfortable.

We have to become comfortable with the uncomfortable. And what that really means is if you're going down a path and you see it's not working, pivot quickly and try something new. So you don't be afraid of those changes. Understand what the direction is, but if it's not working exactly how you envisioned, pivot quickly and move in a different direction. So we really have to embrace that. And as leaders, really be visible to our staff, show compassion because people are dealing with a lot. Show them that you care about them. I'm sure you've heard the statistic, Chris, that people don't necessarily leave their positions and you mentioned the great resignation.

Well, if great resignation continues to hold true and people are leaving positions because of leadership, your number one thing as a leader is to improve your leadership skills and make sure your organization improves the leadership structure. Because if the great resignation continues in any way, shape or form, you want to make sure you're becoming the employer of choice and doing that by having the best leaders that you possibly can. And that all starts with training. That's why one of the reasons that Altius is so passionate about educating and elevating leaders across the board, because you can't become a great organization if you don't have great leaders. Yeah, and people leave.

They go find better leaders. They search out, they seek out leaders that inspire them, motivate them. And if they don't have it, they just feel dead inside. They just feel like this place doesn't really seem to go where I want it to go. And it's super important. I wrote about it in my book, Beacons of Leadership, and it makes all the difference in the world. Well, it's been wonderful to have you on the show and go through all this very enlightening stuff. Thank you very much for coming on. Thank you so much, Chris, for having me. It's been great and pleasure to join you today on the show and go through all this very enlightening stuff. Thank you very much for coming on. Thank you so much, Chris, for having me. It's been great and pleasure to join you today on the podcast. Thank you. Give us your dot coms, if you would, as we go out to help us out with

the show. Absolutely. So the dot com is www.AltiusHCG.com. We're also at Altius HCG for Altius Healthcare Consulting Group on LinkedIn, on Facebook, and on Instagram. You can also follow me on Twitter. It's Stephanie Dorwart and on Facebook and LinkedIn as well. There you go. And we'll have links on the Chris Voss show. So check her out there.

Thanks for coming on the show, guys. Everyone, we certainly appreciate you guys tuning in. Go to YouTube.com, 4Chess Chris Voss. Go to goodreads.com, 4Chess, Chris Voss. Our groups on Facebook, LinkedIn, Twitter, Instagram, all those crazy places, especially Instagram, or I'm sorry, not Instagram, LinkedIn. LinkedIn is the place to be. That newsletter and the group, the big group that we have over there, subscribe to all that stuff. Thanks for tuning in. Be good to each other. Stay safe, and we'll see you guys next time. Thank you, Chris.