The Successes of Learning Health Systems During COVID with Marty Bonick
As the pandemic persists, and the increasing caseload caused by the Delta variant continues to force hospitals to adapt to new challenges, we turn to learning hospital and health systems to understand how they are uniquely positioned to treat patients during the COVID crisis. Chip and his guest Marty Bonick, President & CEO of Ardent Health Services, discuss what hospitals are seeing on the ground during this latest surge. They also spoke about the efforts of integrated health systems, like Ardent, to increase the quality of care for patients during and after the pandemic.
Welcome to Hospitals In Focus from the Federation of American Hospitals. Here’s your host, Chip Kahn.
Chip Kahn (00:13):
As we confront the challenge of the Delta variant, health systems stand uniquely positioned to mitigate COVID-19 for those Americans needing care. Hospital organizations are using their scale and geographic spread to meet community needs, whether in a COVID-19 surge or preparing before it arrives. This organizational flexibility is value add as we contend with the Delta variant.
Today, we will hear firsthand what we think of as learning health systems are coping in COVID hotspots, while at the same time preparing other facilities for possible new surges. Joining me on the podcast today is Marty Bonick, the President and CEO of Ardent Health Services. Marty joined Ardent in 2020 in the midst of the pandemic. He has been working on several efforts, not only to track COVID-19 across his hospitals, but to find ways to improve quality and keep patients and staff safe. Marty, thanks for joining me.
Marty Bonick (01:16):
Great to be here, Chip. Thank you for having me.
Chip Kahn (01:18):
To get started, Marty, would you tell us a bit about how you came to Ardent and your role as CEO?
Marty Bonick (01:25):
Yeah, it’s really quite a story and a special homecoming for me. I’ve been in healthcare administration my entire career, and I started off my administrative career at Hillcrest Medical Center in Tulsa, Oklahoma. And in 2004, Hillcrest became affiliated with Ardent through a purchase. And so I got to work with Ardent for a few years before continuing my career and worked in a variety of different national and regional health systems. And then just last August, almost a year ago today, I started coming back to the organization where I first started my career.
And so today I’m working with our hospitals and facilities. We’ve got 30 hospitals in six states and nearly 200 ambulatory facilities and about 26,000 employees, including the physician providers that we work with. And so it’s a really special homecoming and an honor to be here to work with this talented group of people, helping patients and our communities along the way.
Chip Kahn (02:15):
Marty, you joined Ardent in the middle of the pandemic. What was that like taking the reins during this unprecedented times for health systems and hospitals?
Marty Bonick (02:25):
Well, Chip, it certainly isn’t the way that you would write your fairytale entry into an organization. I’ll say that for certain. But what I found coming into this was an organization that had relied upon its strength of its people and its systems to really help learn from each other and create ways of cascading that knowledge across the organization. So my entry into Ardent, while not the perfect entry or the perfect time to come into an organization, was made all the better by the strong work and people and processes that we’ve had in place to care for these patients.
And as you mentioned, I came in as things were heating up in August last year, and we were still learning how to effectively treat these patients, and the spread of COVID patients across the country was really just starting to pick up and really hit its stride in the late fourth quarter.
And so coming in, I had to quickly assimilate into the organization, trust the people and the processes that had been set up, support them, make sure that the resources were there for them to continue to do mission number one, which is to take care of our patients. And then at the same time, learn the organization and prepare for our next chapter as we continue to build and grow this company and make it a safer and a higher quality organization as we continue to evolve.
So it was certainly interesting times, learned a lot, and just really proud of the way our people are showing up every day during this prolonged period of COVID that we’ve all been dealing with and the world’s been dealing with.
Chip Kahn (03:50):
We’re speaking to you in mid-August, and the recent spike in Delta has been leading to more hospitalizations and illness. What are you seeing on the ground right now across Ardent’s hospitals?
Marty Bonick (04:02):
It’s really interesting. And unfortunately, I think a sign of what’s happening in our country today and this polar divide that we have with largely political ideology. Ardent is caring for patients in six states from New Jersey to Kansas, Oklahoma, Texas, New Mexico, and Idaho. And so we really have a cross-section of America that we’re dealing with.
And I’m really pleased to say that up in New Jersey where the pandemic is ground zero with New York, where we’ve got hospitals just across the river from New York City, those hospitals were at the tip of the spear when COVID started, and we were all figuring this out together. And they have not had a resurgence in COVID. They didn’t have a winter surge. And as of yesterday, we had about eight COVID patients total in our two hospitals.
If you contrast that with what we see going on in the south and our red states, Texas and Oklahoma in particular, we’re seeing rising censuses of COVID patients that are rivaling our peaks that we had less winter, probably 85-90% of the volume and in a very steep increase. We haven’t seen that plateau yet.
So I’m really seeing the divide between those communities that have taken vaccination seriously and the impacts that has had in terms of reduced hospitalizations versus those communities that have not had a strong vaccination uptake. And the correlation between the two is pretty clear in terms of the differences between those that have taken the vaccine and those that haven’t in terms of the impact on hospitals.
Chip Kahn (05:29):
Beyond this divide that you’re describing, are there other things on the front lines that you’re finding concerning right now?
Marty Bonick (05:35):
My biggest concern right now is for our staff, the physical and mental burden that this pandemic has taken on healthcare providers across the country. On the one hand, it’s heroic what these caregivers are doing every day to put their lives on the front line and take care of patients. On the other side, it’s a tremendous emotional and mental burden to continue to see needless death and suffering for a situation in which we have the cure. The vaccinations have proven effective, and we’re not seeing that.
But right now, this Delta variant is highly contagious. We’re seeing younger patients come into the hospital, more ventilator usage, more needless deaths happening across our facilities, and that’s something that could be prevented. And so I think just the physical toll of hospitals becoming overwhelmed. You hear stories in Texas and Florida, Louisiana, where this overwhelm is just taking over the hospital and there’s just not enough staff.
And so our staff want to provide the best quality, the best service to our patients. But when you just have more patients than the systems can handle, it really overtaxes the entire system. And I’m afraid of the burnout and the mental and physical toll that that’s taking on all of our staff and our communities.
Chip Kahn (06:43):
Marty, in the beginning of COVID-19, and you talked about New York and New Jersey when they were this immediate hotspot, your hospitals in New Jersey needed help caring for patients and your hospitals across the country came to their aid. We actually interviewed one of your wonderful nurses the other day who went from Oklahoma to New Jersey to help COVID patients.
How did hospitals work together in this process, both in terms of learning how to fight COVID as well as making sure you had the staff you needed where COVID was hot?
Marty Bonick (07:17):
This is really, I think, the strength of being part of a larger system is when we can help each other and we can learn from each other. And so, as you said, when COVID first struck New York and New Jersey, nobody knew what they were doing. We were all figuring it out on the fly. The one thing we knew is we needed more people, more resources, more equipment, more supplies.
And so our facilities that were effectively slowed down in terms of elective procedures and volumes, waiting to see what was going to happen with COVID, and I think most hospitals were in that situation outside of that hot zone, we were able to send nurses from Idaho, from Tulsa, from Albuquerque into New Jersey and really help our nurses up in that market to care for patients. Because that hospital quickly became overrun with COVID patients. About 60% of all of the patients in that hospital were COVID patients.
And so they had triage tents set up outside the ER. They had patients everywhere with COVID, and we were still trying to figure out at that point how to treat them. So the staff help directly was a support, but ICU utilization was also double what it was before the pandemic. And so we just had a shortage of physician providers at the same time. And so through telemedicine, we were able to bring in physicians from our Utica Park Clinic in Oklahoma to help care for ICU patients through video technology and support, again, our local providers in caring for these patients during that most depressing time that we all started out with.
The strength of our network really helped to provide staff, to provide physician support. And we also set up a pandemic warehouse, because supplies were at a premium and very difficult to find. And so we were able to bring the full weight of our corporate support team to help identify, locate supplies, equipment, ventilators, and make sure they got to the right facilities at the right time when the need was greatest so that our local teams didn’t have to worry about trying to do that on top of taking care of patients at the same time.
Chip Kahn (09:08):
Marty, you bring up telehealth and its use in the midst of the crisis. Clearly throughout this whole period of the pandemic, it has been a game changer in terms of care for patients, both with COVID and other patients who needed care but were worried to go into healthcare setting. So it kept them in treatment without having to expose themselves.
Looking forward to the future, what learnings and changes from COVID will Ardent take from the pandemic like telehealth to continue utilizing to improve patient care and outcomes?
Marty Bonick (09:43):
Telehealth, obviously, is one of those things that we learned coming out of COVID, and it was a great success story. We already had a telehealth program in place before COVID, but we were seeing in the hundreds of patients a month. Just April of last year, a month into the pandemic, we were seeing almost 60,000 patients a month. So we went from zero to 60,000 in the course of a month.
And we all know that healthcare can be slow and take time to get things done. But I think COVID showed us that when we come together as an organization, focused on a purpose of improving what we need to do for our patients and we get laser focused, we can do great things in a short amount of time. And so I think those lessons will continue, and we will continue to challenge ourselves in terms of how do we continue to evolve our healthcare system to better meet the needs of the patients.
What I’ve told our team is we’ve got to treat patients where they want to be treated versus where we want them to be treated. And we will always have our hospitals at the core of what we do, but we have to branch out and continue to find new ways of engaging patients and in taking advantage of the technology and tools that we have at our disposal to make healthcare more seamless and more connected so that we can be involved with our patients, not just episodically when they’re with us in the hospital, but really throughout that continuum of care.
And so we will be continuing to embrace our digital front door ways of staying connected with our patients throughout and offering different ways to access our healthcare services without necessarily having to physically come into one of our facilities as we move forward.
Chip Kahn (11:11):
Touching on innovation, when it comes to quality care, I’ve heard about a new program at Ardent that you’re implementing called Mission Zero. What are you trying to accomplish with this effort, and what will mark success?
Marty Bonick (11:26):
Mission Zero is our high reliability organization focused on patient safety. Obviously, when patients come to us at their time of need, they’re expecting to get well, not to get harmed. And we all know too well that in healthcare, accidents and mistakes happen. It’s never somebody’s intention, but it’s typically when we have systems or processes that have holes that cause unfortunate errors and mistakes to occur.
And so Mission Zero for Ardent is really focusing us in as an organization collectively in terms of how do we make sure that each and every action that we take, every activity that we embark on with a patient is safe and free of harm and error for our patients?
And so for us, zero is always going to be the goal. Anytime somebody is harmed coming into one of our facilities, it’s seen as a failure. And we want to hold ourselves to that high standard so that patients always are going to feel safe in our care.
Chip Kahn (12:18):
How does being treated in a health system like Ardent benefit patients with programs like Mission Zero or other programs you’ve rolled out?
Marty Bonick (12:27):
What we’ve seen in COVID and what we’ve seen outside of COVID is we all are going to learn from each other. None of us is as smart as all of us. And so being part of a large learning organization like Ardent where we can share those best practices, is what it’s about, to continuously raise the bar on quality, safety and patient service.
And so everything that we do, we’re trying to share those best practices and learnings so that everybody doesn’t have to repeat it times 30 in different hospitals in our system. If we had waited for COVID just to naturally go across the country, spread across the country, when we were getting to that point, we learned from New Jersey and those nurses that went there from Tulsa and Albuquerque and Idaho and other facilities, and then the physicians that were helping, they were learning while they were treating.
And we were bringing that learning back across the organization so that when the COVID surge did happen and spread across the country as it did, it may have been the first time we were treating a patient locally, but it wasn’t the first time that we were thinking about what works, how do we best treat those patients, and how do we provide the best outcomes?
And so the result of that was that we saw mortality rates decline through the pandemic as we were learning what was happening. And we weren’t learning for the first time when those patients showed up in our organization. So in everything that we do, we’re trying to share those best practices, learn from each other, and continuously raise the bar on our performance, equality, the safety, and the service we provide to our patients.
Chip Kahn (13:51):
Thank you so much, Marty. This was a great conversation. How can people connect with you and learn more about Ardent?
Marty Bonick (13:58):
You can always go to our website, ardenthealth.com, and learn more about our organization and the great things that we’re doing.
Chip Kahn (14:04):
Marty, thanks for what you do. And thanks for your service.
Marty Bonick (14:07):
Thank you, Chip. Great to be here with you today.
Thanks for listening to Hospitals In Focus from the Federation of American Hospitals. Learn more at fah.org. Follow the Federation on social media at FAH Hospitals, and follow Chip at ChipKahn. Please rate, review, and subscribe to Hospitals In Focus. Join us next time for more in-depth conversations with healthcare leaders.
Marty Bonick is President and Chief Executive Officer of Ardent Health Services. Ardent is one of the largest private health systems in the U.S., encompassing 30 hospitals and more than 200 sites of care across 6 states. Ardent employs more than 26,000 people including over 1,300 employed providers who collectively care for over 2.7 million patient encounters each day.
A veteran health care leader, Mr. Bonick brings nearly 25 years of experience driving business growth through innovation and quality improvement across a variety of health care settings. With experience in for-profit, non-profit, public, and privately held companies, he has held senior management roles in large tertiary and academic medical centers, multi-site systems of inpatient hospital and outpatient facilities, and physician services organizations.
Prior to his appointment as President and CEO of Ardent Health Services in 2020, Mr. Bonick served as CEO of PhyMed Healthcare Group, a national provider of anesthesia and pain management services; Division President at Community Health Systems (NYSE: CYH), where he led operations for a $4.5 billion healthcare portfolio; and CEO of Jewish Hospital and Senior Vice President of Operations for Jewish Hospital & St. Mary’s Healthcare in Louisville, Kentucky. Mr. Bonick began his health care career at Hillcrest HealthCare System in Tulsa, Oklahoma, which was acquired by Ardent Health Services during his tenure.
Mr. Bonick is a Fellow in the American College of Healthcare Executives, and serves as a member of the Boards of the Federation of American Hospitals (Chair-Elect), the Via College of Medicine – Auburn Advisory Board, Community Health Corporation, and ProUnlimited. He holds dual master’s degrees from Washington University in St. Louis in Healthcare Administration and Information Management and a bachelor’s degree in Psychology from the University of Illinois.