The Exec: Making an Impact on Children's Health with Chanda Chacón

The CEO of Children's Hospital and Medical Center in Omaha shares the importance of culture, grit, and being a creative problem solver.

Chanda Chacón, MPH, FACHE, may only be five feet tall, but her passion, energy, and grit make her feel so much bigger as a healthcare leader.

Chacón has a personal connection to pediatric healthcare and has served in leadership roles in the sector for more than 20 years. She currently serves as president and CEO of Children's Hospital and Medical Center in Omaha, Nebraska, which offers primary care, specialty care, urgent care, and virtual care for children and adolescents in the region, and most importantly, officers support to those children and their families.

In a recent interview with HealthLeaders, Chacón shares her career journey and discusses the importance of empathy and grit as a healthcare leader and the creative ways the pediatric healthcare center has worked to address current pain points.

This transcript has been edited for clarity and brevity.

HealthLeaders: What led you to work in pediatric healthcare?

Chanda Chacón: It's probably my favorite story to tell. When I was a preteen, I was in a car wreck and had a back injury, and was shuffled around the medical system for two years. I lived in an area in Texas that had an independent children's hospital, but more than 30 years ago we weren't great at advertising why children's hospitals were better for kids and families.

I had dedicated parents who are committed and struggled in a really challenging healthcare arena to understand what the best thing was to do for me. We went to more than 20 physicians in different health systems in the area and it was a traumatic journey for my family. We finally landed with a provider who was not pediatric; it changed the direction of my life, not only because I ended up having a spinal fusion with him, but I learned about how he was working to help make sure I had great outcomes. I learned a lot about what a great process looked like from him.

What I knew at that point was I wanted to be in the medical field; I wanted to be in healthcare. But I didn't think I wanted to be a physician because I wanted to have an impact on what I thought was the challenge in the [healthcare system]: how complicated it was, how challenging it was for families. I wanted to make sure that I could do something to give people better memories than my family had.

I wish I had a clear path of how that worked, [but] it was more kind of luck. I have an undergraduate degree in biology and Spanish. My graduate work is in public health management. I didn't know exactly where that would take me, but what I knew is when I interviewed at Yale, my advisor had worked in the Partners Healthcare System, and I got very passionate about how I can make an impact. She helped me get on that journey.

At that point in my life, I still had never been in a children's hospital. I started interviewing for administrative fellowships after graduate school. I interviewed at Texas Children's Hospital in Houston … and I remember walking into Texas Children's and I thought, 'I have to work here.' It felt like a place where kids and families could be taken care of. And that really was the start of my career journey in pediatric healthcare.

At the end of my career at Texas Children's I was at one of our community hospitals because I wanted to get back to the core of why I got into this, which was families, relationships, building a system that was powerful, to help people in some of their most challenging times. I got an opportunity to go to Arkansas Children's in Little Rock and try to do what we did in Houston across the state of Arkansas. That was an amazing opportunity because if I truly wanted to make an impact in child health, I needed to go somewhere where I could test the skills and try them out of what I'd learned at Texas Children's. I was there four years as the system COO. I learned how rural healthcare works. When you're in an environment that [has] four kids per square mile, how do you provide care from a children's hospital to families in that environment?

In September of 2020 I came here to Omaha to Children's. The reason I made the journey here was the potential of this children's hospital and the people. That's what powers great organizations and that's what powers awesome outcomes, engagement, and excitement about the work. It's not about facilities or infrastructure, it's truly about the people. When I came here and met the team, I remember thinking to myself, 'This is the most amazing place I've ever walked into.' We had the most passionate, committed people from physicians, food service, nurses, support. We were opening the Hubbard Center For Children. We had great community support. It was about pulling that together to put us in the right direction.

Chanda Chacón, president and CEO, Children's Hospital and Medical Center. Photo courtesy of Children's Hospital and Medical Center.

HL: We're currently dealing with a healthcare staffing crisis that's been happening all over the country. As a children's hospital, how have you fared and how are you working to combat it?

Chacón: We talk about people first, and that we're going to make decisions that put our team members at the beginning of the equation. I truly believe if you do that, outcomes, quality, financial success, engagement, experience, those all are the results of investing in your people. We really double down on that and we're very vocal, very open. We talk about not only creative benefits, but creative ways that we helped people with well-being. We didn't shy away from these challenging times. We don't have all the answers; we were very upfront about that, and very clear about investing in people, investing in our programs that helped people find integration, and do the right thing for them.

Not only was it helpful to the people on our team, it's also been helpful for people we've been recruiting. They know we actually care about them as individuals. For people to feel tied to an organization and feel like they want to live their career out at an organization, you have to provide more than just pay in forms of gratitude. We did a lot of work around engaging our team members in ways that let them know we saw them, that we heard them, that they were valuable.

That also programmed us to look at how do we operate differently. The challenge in this time was that it wasn't just short staffing on the nursing side, it was every role [for which] we didn't have enough people. That was new for us, and so we had to start looking differently at how we did work, and how do we create teams that are efficient and effective to get work done in different ways, and not wait for it to go back to normal.

There's some good with pushing us to think differently about the work we do, and how we do it, and get more creative. I truly see it as an opportunity, not as woe is me, woe is us in healthcare. We just have to figure out how to be different, how to be excellent.

HL: What are some pain points you're focused on?

Chacón: The people side of it is a huge top priority, always, because that's what powers the work we do. So how do we become the employer of choice? How do we get people across state lines to come work here? And tell our story more broadly?

As we think in the pediatric space, how do you provide access to amazing pediatric healthcare that we can provide in an independent children's hospital to rural parts of our state? This is not unique to Nebraska, it's many states that look like this. How do you do that in a way that makes that care accessible but also not duplicative, [where] you can leverage a smaller footprint of staffing or of infrastructure to provide that care? Telehealth is a great way to do that. Partnerships and relationships that aren't bricks and mortar, but allow you to see families close to their home. Digital technology framework is going to be so powerful; it has been already; it's been a great uptick during this last couple of years to help us provide a seamless level of care.

We have some amazing programs that we're doing at Children's. Project Austin is one of them, that allows us to take our most chronic children who are stable, but live in rural parts of our state, and allows us to [give the family] the medical record of their information. We've created an app for this so that our EMR is loaded in, there's a QR code that is either on that child's wheelchair or their car seat. We go into the community, we train EMTs, we train paramedics, we train the healthcare providers in that city where that child lives to say, 'Here's what this child's normal looks like. It might look different, but here's their challenges and here's how you can help them stay close to home as long as possible, safely, with high quality.' Those kinds of programs and that creativity and uniqueness for those niche markets and populations is really going to be essential.

The other piece is around mental health in the pediatric population and adolescent population. We are not unlike the rest of the country in the surge that we are seeing in our emergency departments, primary care, specialty care. We've got to do better. It's incumbent on us in children's health to do that. We're doing work now in Omaha, working with our community and some really generous donors to build a campus that is an inpatient facility of 38 beds. It will also have 40 partial hospitalization appointments a day, a primary care clinic, our outpatient behavioral health, eating disorders program, and urgent care. We're building that hub, but we're also building the spokes that go out further into the community, because our goal is to get ahead of that curve to work with partners in the community, work in schools with educators, and help.

I'm proud of the partnerships we have, not only with community partners, but with other healthcare partners. Normally, you see competition and we're not seeing that in our space. We're seeing that partnership and support from the state as well. It's something we have to do to make sure that we have a healthy population in the future in all of our states.

About 50% of kids are covered by Medicaid, so that's always top of mind for us because if we can keep kids healthy, we keep communities healthy long-term. It's important that we look at understanding who Medicaid serves, and if it's serving half of our kids, we have to have that top of mind to consider that as we move forward.

HL: What advice do you have for women and others who are interested in working in healthcare leadership?

Chacón: You have to have grit and grace. The grit to be persistent to go after hard challenges, hard problems, and the grace to realize you're not perfect, and that you should chase excellence not perfection.

For me it was about chasing excellence. I always wanted to build my toolkit to be able to be the person that people would have to pick because I prepared myself so well. It was more about being the kind of person that was a lifelong learner in leadership, so that people saw I can adapt and be agile as we change in healthcare.

I would encourage people to realize that you have to be persistent and knowing that failure is just an opportunity for you to try something else and not give up. There were so many times where I could have said this is too hard. And instead, I just said, 'Hey, I've learned a ton from this. What's the next pivot? Where are we going to go? How are we going to do this?'

Healthcare is hard. But anything that's worth having is worth struggling and striving for. We need great leaders in healthcare who are willing to do that.