The Exec: How to Drive Innovation in the Hospital Setting

Innovation initiatives help hospitals to improve the quality of care, this new chief medical executive says.

In the hospital setting, frontline staff should be leaders in innovation, the new chief medical executive of a Sutter Health hospital says.

Anup Singh, MD, became chief medical executive of California Pacific Medical Center this month. He was previously chief medical executive at another Sutter Health hospital, Sutter Santa Rosa Regional Hospital.

"The first key driver of innovation in the hospital setting is relying on frontline leaders and physicians for innovation rather than the C-suite," Singh says. "You need to reach out to frontline team members to ask for suggestions. When you ask them questions, you will get significant innovative answers from them."

In addition to relying on frontline staff for innovation initiatives, ideas can come from outside a hospital, Singh explains.

"Leaders should look across their health system and across the country to see who is performing best in terms of metrics and how they are doing it," Singh says. "You need to learn from others about best practices and innovations."

To promote innovation, CMOs and other hospital leaders need to be open to new ideas, according to Singh.

"If you are not open to new ideas and if you are not flexible, people will not have the psychological safety to come to you to talk about innovations," Singh says.

Singh gave an example of an innovation initiative at Sutter Santa Rosa Regional Hospital.

"We had an innovation initiative for congestive heart failure patient readmissions," Singh says. "We did not have enough outpatient physicians or cardiologists to see the patients. We could not see patients quickly enough."

The initiative focused on enlisting pharmacists to engage patients.

"We had our pharmacy team call these patients within 48 hours of discharge as well as connect patients with home health services," Singh says. "We were able to talk with patients and adjust medications to improve their care."

Anup Singh, MD, is chief medical executive of California Pacific Medical Center. Photo courtesy of Sutter Health.

Improving care quality

Hospital readmission is a key quality metric, according to Singh.

When Singh became chief medical executive of Sutter Santa Rosa Medical Center in 2023, one out of six congestive heart failure (CHF) and heart failure patients were being readmitted to the hospital within 30 days. The hospital took several actions to reduce these readmissions.

The hospital was able to reduce the amount of time it took for CHF and heart failure patients to get follow-up appointments with cardiologists. Patient engagement was improved with the pharmacy and transitional care teams. The hospital worked more closely with the home health team, which engaged with patients and helped to manage medications.

"By the end of the year, we were able to decrease readmissions from 16% to around 9%," Singh says.

Patient experience is another crucial quality metric, Singh explains.

"When you talk about patient experience, it is not only about care, but also knowing the patient as a person," Singh says.

Hospitals should take a team-based approach to improving patient experience, according to Singh.

"It is not only the physician—it is the nurses and the rest of the care team," Singh says. "When we talk with a patient, we talk with them not only as a patient but also as a human being. We need to know them and what they like such as their hobbies."

Communication is pivotal in patient experience, Singh explains.

"We want to narrate the care in a way that the patient understands," Singh says. "We want them to be aware of what is happening in their care."

Improving care coordination

Health systems need to focus on patient engagement to improve care coordination, according to Singh.

"We need to take care of the patient with continuous care, not just care when they are in a clinic or a hospital," Singh says. "We should be in touch with the patient in way where we are taking care of them even when they are not in a healthcare setting."

CMOs and other healthcare leaders need to ask themselves pointed questions to provide good care coordination, Singh explains.

"How are we taking care of a patient? How safe are we providing care to the patient? How are we connecting with the patient once they are at home?" Singh says. "We need to be providing follow-up appointments to patients, so they are not coming back to the hospital, and we need to provide care to patients once they have gone home."

Care teams in various settings need to work together to boost care coordination. According to Singh, CMOs need to have outpatient teams coordinating with inpatient teams as well as home health teams.

"When we have patients go home from the hospital, home health staff connect with these patients, so there is a continuous connection with the patients," Singh says. "Our home health team works on the same electronic medical record as our hospitals, Epic, so documentation is visible to outpatient physicians."

Having care teams on the same EMR is essential for care coordination, Singh explains.

"When the home health team goes to the patient in the home, they are collecting data, and they are talking with the patient," Singh says. "If problems arise that require intervention, our home health staff has the option to send messages to the outpatient team, whether that is a primary care physician or a specialist."