Hello, everyone. Welcome to the Becker's Healthcare podcast. I'm Mackenzie Bean, AVP and managing editor of Becker's Healthcare. Today, I am so thrilled to be chatting with doctor Andrea Turner, the CEO of Harbor UCLA Medical Center in Torrance, California. Andrea, thank you so much for being back on the pod with us. How are you doing today? I'm doing great. Thank you so much for having me, Mackenzie. Of course. Thanks for being here. So as you look back on 2024, what are you most proud of? Well, I started with Harbor back in February, February 26, to be specific, of 2024. And there were meaningful work actually, started, so I can't take credit for a lot of it. I will just say what I'm most proud of is how we've been able to build more capacity and access, through our ED and also, the way that we we've approached health caring. So one of the things that we've been working on, specifically is around how we deliver care. And what I mean by that is from in a holistic way. So for example, if a patient suffers a trauma type, event and they come through our trauma, bay and we care for them, it's not just as simple as to say we're going to send them to the sniff, but how do we give them access to research that may be helpful for their care in the long run? And so we've we've started to look at how we care for the entire patient, to include their families and sharing with the families what other alternatives are there, in in in in the specific general community. So that's one of the things that we've we've done a lot of work around. The other thing that I'm really proud of is how we've approached, case management. And any CEO will tell you that length of stay is something that we're all working on. So throughput for our hospital is is actually getting much, much better, and it's because of our utilization management. And so, the team, my my CNO and my CMO have been working really well together and, being supported by the COO to to do case management very well where the throughput for our patients are, are getting better. The other area of improvement that I think I'm I'm equally proud of is our staff around wellness. So I think when when the pandemic happened, we went into this, like, savior mode and health care did an exceptional job. But we forgot about ourselves and how we we care for for ourselves. And I think, you know, we've seen many, many, people leave health care. And, and part of it is owed to, the amount of stress that came with the pandemic and caring for others while seeing the demise of of so many. And I think for us basically looking at how can we support the the teams and ourselves and being very intentional about it. And so with within the system, we we have a chief wellness officer, and each of the organizations within the system has a chief wellness officer that cares for the the team members. And might I say, we're in in the sense of being intentional. These are all ways of managing stress and caring for yourself. And it it is rooted more or less in it's not just simple as looking at one individual and using whatever is going on with that individual with another individual. It's truly more or less it's it's based on the person. So it's individual like, looking at the individual using whatever it is that we need to do to care for that individual to make them whole. And I'm talking about our staff now. And so I think, Hoda, who is our psychologist, runs our our wellness program, has done an exceptional job. And so we're we're very intentional about our our staff, our patient care, and and just our culture and our environment to make sure that we're we're all fit to take care of the patients that need our expertise. Mhmm. It's clear that intentionality and care is really infused and, everything that the hospital is doing. You mentioned those successes in ED capacity, length of stay, and case management, and, of course, your staff wellness focus. Sounds like you've, been pretty effective in your roles in in the last, twelve months or less. Yeah. Yeah. It's, you know, and and, again, I think it's it's you you mentioned it in a in a very comprehensive way. And I'll just say, in addition to that, I think we're seated right in between Carson, Torrance, and this catchment area from Long Beach all the way to LAX. And, and we're trauma level one. So for us, it's a go, go, go, go, go. You know, consistently, our census is is usually very, very high. And we're we're we have to have really good efficient flow, starting from, you know, the moment the patient gets in, you know, caring for the patient to to, to improve their situation. And I think for us, it's making sure that all the right pieces are in place to do that. And if if the foundation is cracked, which is, again, our staff, if if that's not well, then it's virtually impossible to do an effective job. So I think we've recognized that, and it's not just us. I'm sure, you know, across the health care continuum, we've we've recognized that that we must take care of our our, our our employees. And that's what we're doing here. Mhmm. I know we've spoken with so many leaders who have shared that they really are focusing in on, capacity management and a lot of those Mhmm. Challenges in 2025. I think you're so right to point out that so much of this starts with that foundational work and, taking care of the care taking care of the caregivers who are helping lead all of this work as well. Correct. Correct. Yeah. So let's look at 2025 then. Mhmm. How are you planning to build on this work? What type of organizational goals are you setting over the next twelve months? Oh my goodness. So if you try to do too many goals, usually, you don't achieve any. Right? And so for us, we're building a whole new campus. So that's that is in itself a a big feat, and, we are the hospital for the 2028, Olympics, which will be held right here in LA. And so we are getting ready to have a state of the art, entire campus will be state of the art. But for 2025 in particular, it's literally to build access and flow, in the sense of being you can't be everything for everyone. At the same time, we have to be effective at what we we need to do. So we're good at many, many things here to include ortho, neuro. We we do transplant. We do, and, again, like I mentioned, we're at trauma level one. So for 2025, we're looking at improving our patient outcomes. Right? So I and when I say that, I mean from the primary care perspective, like, again, making sure that our outreach is is much better, that we, for our empaneled patients, that we can get them in timely so that we can we can do preventative care. So that's one one arm of it. The other part is to look at cost containment. Undoubtedly, we all know that health care, we have opportunities to decrease our waste and and build in more efficiencies within our our systems and and create a, culture where we're all accountable and we're we're working, to to basically improve in those spaces. So I think for us, it will be to cost containment will be one of them. You know, again, retention of our our amazing staff and recruiting for, exceptional talent, building capacity, again, and, you know, quite frankly, access and flow. Getting patients discharged timely, making sure that we adhere to rules and regulations. Those, unfortunately, you know, they change not often, but they change. And so making sure that we are working in a space where we are being regulatory compliant, that we are supporting our staff and and, again, mitigating any type of situation that could cause harm to our patients. So that's that's a big part of our, goals for this year. The last thing I will say is around security and safety. So we we'll talk about quality in in a few minutes, I hope. But security and safety for for our campus is very important. I wanna make sure that our team members who, work here feel safe coming into work and have the tools that they need in a safe environment to perform their duties. And so that has been something that, from a system perspective, we are focused on, to make sure that we, that our partners in May maintaining our safety on campus and around the surrounding area, that that they're, that we're working well together to make that happen. And the fact that safety is everyone's responsibility. So those are some of the things that we will be continuously focused on. We are also, we have the desire to be a leapfrog a, a rating of a. So our the the way that we've designed our strategic goals, basically, is to is to get us to a leapfrog rating of a. And and so that's that's those are our goals right now. Exciting goals. And I know you mentioned, you know, part of it being creating that culture of accountability. I think that goes also draws into the safety and quality piece very much. Mhmm. Mhmm. Correct. Correct. Cool. So as you're looking into, you know, these core focuses for your hospital, over the next year or two as you're tackling them, what sort of headwinds are you preparing for? I I'll start with, recruitment. It is something that we're all struggling with because we're after the same talent, where, LA is pretty expensive to live. So, definitely, when we think about recruitment, we are also thinking about salaries and things of that nature and competing with we have a lot of traffic, so that is also another area. And I I'll just say, you know, for us, it's going to be, looking at recruitment and recruiting in a diverse way, right, with, the EDIA lens, which is equity, diversity, inclusion, and anti racism. And so for us, it's how do we get staff that look like the community that we serve and making sure that this is where they want to spend, if not all their career, here, you know, at least the majority of their career is here. And so that's part of it. The headwind in that is, like I mentioned, is is how to recruit those talented folks to come here from across the country, you know, to come and live in in a space where it's more expensive to get five miles within the city. It's, you know, close to thirty minutes or or more. So that that continues to be a problem for us in in the recruitment speak space. And I won't say for every area, like, you know, there are some areas that people will come and and take those jobs and and all that, but, recruitment continues to be one of the areas of of challenge for us. The other headwind, I think, is is around regulations and, and there I say it, around, finances. Right? I mean, you know, with, making sure that we decrease our our denials, with the insurance companies and making sure that, we are bill billing correctly. So that's those are some of the areas that I I see where headwinds and and cost containment. I mentioned earlier around mitigating waste and building a culture where everyone, owns efficiency and effectiveness all at the same time and understanding, how to to, decrease waste. And so that in itself, I would say, internally, that is a headwind that, we are certainly working, judiciously on. The last thing I will say is, for safety net hospitals, like ours, we deal with, patients that are very, very, very sick. When they come in the hospital, they are not leaving the next day or three days or four days or five days. They're usually very, very sick. And so it's to manage that population in a way where we, can, like I mentioned earlier, to do more or less preventative care and outreach. And so that is one of my focus here, is, again, building capacity in our primary cares, but also doing outreach to get patients in so that we can get to their disease process, if you if you will, earlier so that we can help them to live a much better, healthier life. So those are some of the things that we are challenged by. At the same time, we have to strategize, in how we are going to make our community a healthier community. Absolutely. Especially for, an organization like yours that plays such a a a key role, with those sick populations as you said. Mhmm. And we just have a few minutes left. Are there any other, final thoughts that you'd like to leave our listeners with? Certainly. I I think, you know, for health care, I think we have an uncanny ability to to partner well. And I will say that for for us here in LA, we we do that fairly well. And I would think for for health care, we are going to have to change our mindset on how we do that. And I don't have all the answers in that space, but I do think for us, it's more or less that we are managing our communities in a way that it's more on and this is not new by any means, but it's it's going to be more on prevention. And I've said this before in different spaces that we cannot be in the in the rear. We have to stand up in the front to to talk about the things that health care or health caring will need to be be successful. We know that we take up a lot of the GDP. I mean, we hear it. And we, as a health care organization, I think for us, it's continuously thinking about how do we spend our dollars in the way that we can care for our patients, have great talented, experts to do this work on behalf of of our our community. And at the same time, where we have a an environment where they can thrive. And so I think, you know, we we're doing a decent job, but we need to get better. And I I look for having forward to having great partners in this space. So once again, I just wanna thank you for having me, here today. It's been a pleasure. Thank you so much, Andrea. It's been, so great to hear about the work that you're leading at Harbor and just appreciate your time so much. Thank you. Thank you again. And to our listeners, thank you as always for tuning in. You can find more podcast episodes by visiting the Becker's podcast page at beckershospitalreview.com/podcast.