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The Exec: Accommodating Population Growth Top Priority for AdventHealth Chief Clinical Officer

Analysis  |  By Christopher Cheney  
   July 26, 2023

AdventHealth expects Central Florida population growth of about 6% over the next four to five years, with a related increase in demand for healthcare services.

Meeting the challenge of population growth in Central Florida is the top priority of the new chief clinical officer of the AdventHealth Central Florida Division South Region.

In March, Victor Herrera, MD, became chief clinical officer and senior vice president for AdventHealth Central Florida Division South Region, which features 10 hospitals. His prior positions at AdventHealth include serving as chief medical officer and vice president of AdventHealth Orlando, the flagship hospital of the Altamonte Springs, Florida-based health system. He also served as medical director of continuing education at the health system.

HealthLeaders recently talked with Herrera about a range of issues, including medical education, quality improvement initiatives, and change management. The following transcript of that conversation has been lightly edited for clarity and brevity.

HealthLeaders: What is your top priority in serving as chief clinical officer of AdventHealth Central Florida Division South Region?

Victor Herrera: The population in Central Florida is growing. In the next four to five years, we anticipate that we will have about 6% population growth. We estimate that will be 150,000 to 200,000 new people in this area. I see getting ready for this population growth as our top priority. From a healthcare perspective, we expect an increase in demand for healthcare services.

The population growth will bring pressure in terms of building our access points, creating an infrastructure that meets the needs of that growth, and thinking about our workforce. Coming out of the coronavirus pandemic, there have been constraints related to workforce, and we are in the process of thinking through our pipeline for providers. We need to not only hire more people but also change the way people work, so we can take care of more patients without increasing the burden on care teams in a way that is unsustainable.

HL: How do you plan to rise to the challenge of making sure you have the workforce to serve this growing population?

Herrera: We will have to pursue innovation in how we deliver care. We anticipate that we are going to do more things outside of the hospitals. We are going to see more care at home. When it comes to the care model, it is going to look very different five years from now. We are going to redefine hospital care—it is the only way that we can match the demand for services.

Obviously, technology is going to have to be one of the tools that we are going to have to leverage as part of this transformation. There is the potential to use artificial intelligence and machine learning. We need to remove the burden that is associated with tasks that are tedious and take a lot of time for our workforce. We can probably automate many of these tasks, which will free up time for frontline healthcare workers to deliver care. It can also improve satisfaction in the workforce.

Currently, nurses spend up to 40% of their time documenting and doing tasks that we believe we can automate. So, it's not just about adding more people. It is about changing the work of the people we have already, so they have the capacity to see more patients.

Victor Herrera, MD, chief clinical officer and senior vice president for AdventHealth Central Florida Division South Region. Photo courtesy of AdventHealth.

HL: You have experience in medical education. What are the primary qualities of a good medical educator?

Herrera: We have a large medical education footprint in our health system, and we continue to grow it. We are training the next generation of physicians, and our goal is that most of those physicians will stay with us. When it comes to the key qualities of a good medical educator, things have changed a lot. If I go back to when I was a medical student, most of the knowledge that I was acquiring came from attending physicians and faculty. I would ask them questions, and that is how I learned.

The world has changed. There is so much information now that we need to know and be able to find. We cannot just rely on individual educators to pass along that knowledge. We need to teach our trainees how to use the tools that exist, so they can go on their own and find information. In 2023, a good medical educator understands what information tools exist and focuses their training of students and residents on how to use those tools to find information. In addition, a good medical educator teaches clinical judgment, which continues to be a core area.

HL: What are the primary elements of advancing population health?

Herrera: We need to leverage artificial intelligence and machine learning to characterize the populations that we serve. We need to have access to data and focus on the outcomes we are trying to influence. We need to focus on the predictors of outcomes. Artificial intelligence and machine learning will give us the ability to process data and find signals that were not obvious to us in the past. This will take us to a new level of delivering on the promise of population health. This is a big opportunity—how we can leverage technology to understand data to have predictive value for our patients.

HL: What are the keys to success in quality improvement initiatives?

Herrera: When we talk about quality improvement, we need to go beyond a particular care team and saying their quality needs to be better. As leaders, we need to get to the root cause of why we are getting the results that we are getting. Sometimes, we fail to think that way. If we are not getting the results we are hoping for, there is a reason for that. There are drivers or incentives that prevent you from achieving what you want to achieve.

The root causes are often not obvious, and sometimes we jump into quality improvement initiatives without understanding those drivers. Understanding root causes is the key to quality improvement.

HL: What are the keys to success in change management?

Herrera: It is similar to quality improvement. You need to understand the drivers of what you want to change. In addition, you need to have good communication with everyone who is involved. You need to get to the front line and determine why we are doing what we are doing. So, you need to find root causes and establish communication all the way to the front lines.

HL: What is your approach to team leadership?

Herrera: You need to create psychological safety among your team members. You need to create an environment where people feel comfortable telling you what they think. In healthcare, we take care of patients, and taking care of patients comes with a high bar in terms of expectations. We are always trying to achieve excellence in everything that we do. At the same time, we need to create an environment where people feel it is OK to fail. If we are not getting the results that we need right away, my leadership style is to say that is OK; otherwise, you will stop innovating. If you are going to innovate, you need to feel comfortable with the idea that innovations may not work the first time.

My leadership style is to push my team to think outside the box, to try new things, and to innovate. You are not going to get your team to innovate if you do not create psychological safety.

Related: The Exec: WMCHealth CMO Renee Garrick Talks About Facing Current and Future Clinical Challenges

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

To meet the expected increase in demand for healthcare services, AdventHealth plans to conduct care model transformation and automation designed to bolster the health system's workforce.

Good medical educators equip students and residents with tools to mine the vast trove of clinical information.

Artificial intelligence and machine learning have the potential to advance population health efforts.


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