Pediatric Health System CEO Shares Pandemic Perspective

Matthew Love, CEO of Nicklaus Children's, shares his lessons learned in leading the pediatric health system through the pandemic and explains how the virus impacted the system's pediatric patient volumes.

The COVID-19 pandemic may have disproportionately affected adults, but children weren’t immune from the virus. The American Academy of Pediatrics and the Children’s Hospital Association have reported that almost 13.3 million children have tested positive for the virus since the onset of the pandemic in 2019.

Pediatric hospitals and health systems also weren't immune to the pandemic effects, and have faced the same hardships that adult hospitals and health systems have over the past couple of years. These pain points include staffing issues, drops in patient volume, and navigating a novel disease.

One of those organizations is Nicklaus Children's Health System, a pediatric health system serving Miami Dade, Broward, and Palm Beach counties in Florida. According to the health system's president and CEO, Matthew Love, the organization has a workforce of 4,000 that serves about half a million children across its locations, including a primary hospital outside of Coral Gables and over a dozen ambulatory locations.

Love recently spoke with HealthLeaders about his experience leading the pediatric health system through the pandemic, how the virus impacted the system's pediatric patient volumes, and shared his learnings from the past couple of years.

This transcript has been edited for clarity and brevity.

HealthLeaders: What was your experience leading a children's health system through the COVID-19 pandemic?

Matthew Love: From a pediatric perspective, we were glad that it was not primarily a pediatric event. Kids got sick, but it was much more of an adult issue.

For us, it primarily [affected] our volumes, similar to most children's hospitals across the country, where we saw significant decreases in volumes almost overnight. Primarily, no children's hospitals were backfilled with COVID patients because there weren't very many COVID inpatients early on in the pandemic.

We had similar issues on the adult side with staff: staff were afraid, staff were sick, staff had to deal with kids saying home from school, those types of things.

HL: How were the health system's financials affected by the volume drop, and how did you offset that?

Love: From a financial perspective, we saw volume pretty much drop over 10% over the prior year. With that corresponding drop in revenues, we were able to look at our operating structure, and we addressed some of those shortfalls on the revenue side by reducing expenses. We furloughed non-patient care staff, executives and middle management took pay reductions, we suspended some pension contributions, and of course we looked at some of the non-essential things in purchase services, such as travel.

HL: How did the pandemic affect the children population that you serve?

Love: Outside of some of the very sick kids that were admitted, most of the impacts were in our ambulatory locations. Parents wanted to bring their kids in for testing, [and they] were afraid that their kids had symptoms, whether it be fever or cough. We saw increases in our emergency departments and urgent cares, for example, because parents were concerned.

We were able to set up an inpatient unit dedicated to kids with multi-inflammatory disease, also called Kawasaki-like syndrome, and took care of a decent number of those kids during the pandemic.

We quickly set up a vaccine clinic here on our campus for kids. Our trained pediatric nurses floated through five days a week or so during the early part of the pandemic, and having that vaccine clinic available as a walk-in model to vaccine kids [improved care coordination].

Some of our staff became aware of some kids in a shelter south of Miami. We went out, got their parents' permission, and we were able to help about 40 or 50 kids [get vaccinated].

HL: What were your main learnings during the pandemic and how will you take those and apply them to the future?

Love: When we were going through the middle of the pandemic, communication and the importance of listening to our staff, listening to their concerns, responding to their concerns, [was important.]

We learned that, for example, working from home and hybrid work were actually a viable option. We continue to implement some of those hybrid work practices for non-clinical staff, shrinking our real estate footprint.

And then telemedicine, I hope, is here to stay. It's a great way to improve access to care to pediatric specialists, and the pandemic was an accelerator of that. We saw a ton of kids through telemedicine and that continues today.

HL: How has the pandemic affected the health system's growth strategies?

Love: There was almost a pause on some of the things that we were trying to do strategically, but then as we realized that this wasn't going to be a short event, we had to pivot back to our growth strategy.

One of the things I'm very proud of in south Florida is our ability to partner and affiliate with adult hospitals. During the pandemic, we were able to partner with Baptist Health South Florida. The partnership allows us to do what we do best, which is take care of kids, and allows Baptist to do what they do best, and that is to take care of adults.

We hit pause on growth for a year or so. And now we're back to growing our clinical services through our heart program, neuroscience program, [and] ortho and cancer programs, [through] additional locations, and [by] continuing to partner with folks to provide pediatric healthcare in their communities.

HL: What advice do you have for other pediatric health system executives?

Love: What I would suggest folks do is build a great team around you. I feel very confident and comfortable with the team that's here at Nicklaus Children's. I don't know what the next thing is going to be, or when it's going to happen, but I am 1,000% confident in the executive team, the nursing team, and the frontline staff that will get through it. [We are] able to be flexible and nimble with the right team and being able to deal with anything that gets thrown our way.

I would also like to challenge everyone, whether you're in healthcare or not: how do we make pediatric healthcare better? Let's rise to that challenge and set high priorities for the healthcare of our children. In that scenario, everybody wins of making pediatric health care a top priority for our communities.