Phoenix Children's Hospital has added a new emergency department and will open two free-standing hospitals in 2024.
Balancing growth with operational excellence is the primary clinical challenge at Phoenix Children's Hospital, says Jared Muenzer, MD, MBA, chief physician executive for the pediatric health system and chief operating officer of Phoenix Children's Medical Group.
Muenzer was named chief physician executive in August and has been chief operating officer of Phoenix Children's Medical Group since 2016. His prior leadership roles at the pediatric health system include physician-in-chief, associate director of the emergency department, and vice president of the medical staff.
HealthLeaders recently talked with Muenzer about a range of issues, including physician leadership, physician engagement, and the keys to success in managing service lines. The following transcript of that conversation has been edited for clarity and brevity.
HealthLeaders: What are the primary challenges you’ve seen as chief physician executive of Phoenix Children's?
Jared Muenzer: The biggest challenge for me is balance. We have set out on a massive growth campaign—we have added an emergency department in the West Valley, we are adding 40 beds on the main campus, and we are adding two free-standing hospitals in 2024. Balancing that growth with operational excellence, a strategic plan for operational improvement, workforce development, and workforce growth, and putting it all in one package and getting it to function and flow are the biggest challenges.
The beauty for us is that the team within the medical group and the hospital both from a physician leader standpoint and an administrative leader standpoint are definitely up to the task. They are the ones who drive the improvement and the change.
The other challenge I would add is technological advancement. We need to slide technological advancements into our changes. We need to make sure that technological advancements fit and drive improvements for our patients and our families.
HL: How do you address those challenges?
Muenzer: We have tremendous physician leaders in this organization. In Phoenix Children's Medical Group, we have 34 division chiefs, and we are helping them understand their book of business and working with them to understand what their needs are. We are partnering them with administrative leaders.
When I took over as chief operating officer of the medical group in 2016, I had two directors and about two dozen managers, and that has grown to four vice presidents, a dozen directors, plus about 30 managers. The partnership of the physician leadership and the administrative leadership allows us to develop the cadence and the projects as well as tie in the technology so that all of the challenges I have talked about get addressed.
HL: What are the keys to success in physician engagement?
Muenzer: With the growth, we were at 300 providers in 2016 and we are at more than 800 today. We had 26 divisions and now we have 34. Physician engagement is really about the development of the leaders. My goal for them is to say, "You own your book of business—you run it." I want to empower them to do that and find out about their needs and resources.
Then I want people at the executive level to say, "We still are a children's hospital with limited resources, but how can we maximize those resources to give all of our physician leaders and all of our books of business the attention they need to drive world-class healthcare for our patients and their families?"
Jared Muenzer, MD, MBA, chief physician executive for Phoenix Children's Hospital and chief operating officer of Phoenix Children's Medical Group. Photo courtesy of Phoenix Children's Hospital.
HL: How have you managed growth strategies and process improvement for the medical group?
Muenzer: It is all about the data. We need to understand our patients and families, our community, our state, and the Southwest in terms of what the needs are in pediatric healthcare. We need to utilize the data. What are the wait lists in our divisions? Where are patients coming from in the state? What procedures do they need? For the things that encompass healthcare, understanding the data behind it allows us to focus not only on areas of growth but also what pace we need to grow at. We determine what growth needs to be then develop individual strategies to do that.
One of the big areas of growth has been our residency program and our fellowships. We are now up to 30 fellowships across this health system, which helps serve growth from a provider standpoint.
We also have a large contingent of advanced practice providers in this organization, and we have relationships with numerous colleges that produce nurse practitioners and physician assistants. Those relationships drive advanced practice providers here for rotations, which helps them fall in love with pediatric healthcare and drives workforce development.
HL: What are the primary elements of physician leadership?
Muenzer: Servant leadership is important. Accountability is important. One of the things that I love about our physician leaders goes back to the book of business and the dyad model of leadership. When our physician leaders take accountability for their book of business, their growth, and their strategic plan, it helps me and the organization drive change and the growth that we need. It also helps them because when they hold themselves accountable, it helps their groups to be accountable.
The other big piece of physician leadership is effective communication. When my physician leaders effectively communicate not only with their physicians and staff but also with me and the organization, it is a game changer to drive necessary change.
HL: How do you define servant leadership?
Muenzer: It involves accountability; support; open communication; listening to the people around you; engaging the people around you; putting together the needs, wants, and asks of the people around you; and being willing to translate growth and cadence of growth. A servant leader makes sure the people around them feel that their voices have been heard.
HL: How are physicians involved in administrative leadership at Phoenix Children's?
Muenzer: Physicians play an important role as division chiefs.
We also have developed numerous channels and avenues for our physicians to have a voice and to engage in leadership. We have committees in the medical group, which involve understanding operations, understanding strategic growth, and understanding patient safety and quality. We have aligned physician leaders in the medical group with physician leaders in the hospital, so that the medical group and the hospital are aligned. That applies to patient safety and quality, so we have patient safety and quality leadership as well as medical directorships on most of the floors in our hospital, in our emergency department, and in ambulatory clinics that align with nursing quality leadership and quality office leadership. So we are all aligned.
We also have alignment across operations as well as across compliance and the regulatory function, so we have a system that drives partnerships that support the goals of the whole institution.
HL: You have helped to add or expand several divisions at Phoenix Children's, including nephrology, infectious diseases, anesthesiology, and neonatology. What are the keys to success in managing service lines?
Muenzer: With our growth, one of biggest challenges is that when you bring new groups in, or when you are growing a group from scratch or growing a group fast, is to make sure you understand culture and you understand the best avenues for communication. In the growth stage or the onboarding stage, you set the tone for the future. We have tried to make sure that everyone feels like they are part of the Phoenix Children's family and part of our culture, which is striving to provide the highest quality of care possible. We have supported our new or expanded groups to meet that goal.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
When a health system is experiencing growth, it is important to balance operational excellence, a strategic plan for operational improvement, workforce development, and workforce growth.
Physician leaders are the key to success in physician engagement.
Servant leadership and accountability are primary elements of physician leadership.